Background: Coronavirus disease 2019 (COVID-19) is an infectious disease that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. On February 29, 2020, the first United States reported its first death3. On March 8, St. Louis County and Missouri saw their first case4. Despite ample research coming out about COVID-19, its causes, and its effects patients, little research has come upon the disease’s relationship to other conditions. More specifically, research on patients with sepsis has largely been limited. However, with more scientific data becoming available on COVID-19, the relationship between the two can now be better studied. Recently, the Global Sepsis Alliance stated that COVID-19 does, in fact, cause sepsis9. Patients with COVID-19 and sepsis are more likely to be hospitalized. In addition, patterns of hospitalizations shown by patient records display that certain demographic groups are more likely to be hospitalized for COVID-19 than others. This study seeks to examine which patient characteristics affect the rate at which patients expire from sepsis during the COVID-19 pandemic.
Methods: Patient records were obtained from SSM Health Saint Louis University Hospital located in St. Louis, Missouri. SSM Saint Louis University Hospital discharge data was extracted from the Vizient Clinical Data base. The database is used to study key outcomes measures such as mortality, length of stay, complications, readmission rates and hospital-acquired conditions13. The time period with which the data will be analyzed and recorded is from April 2020 to June 2020. There were 366 patients with the diagnosis of sepsis of which 71 patients were diagnosed with COVID-19. Three patients were 3 repeated encounters and those were excluded from the overall sample.
Results: There were equal numbers of African American (176 patients [48.5%] ) versus Caucasian (176 patients [48.5%]) patients admitted with the diagnosis of sepsis during this time period. Females accounted for 41.9% while males accounted for 58.1% of the sepsis admissions. The patients age range from 18 to 95 with mean age at the time of admission was 60.8 years with a standard deviation of 15.01. Uninsured patients accounted for 5% of those admitted, commercial insurance 16%, Medicare 52.6%, Medicaid 24.2% and military 2.2%. During the study time period 82 patients (22.6%) expired with the diagnosis with sepsis. By means of logistic regression patient characteristics contributing to likelihood of mortality with a sepsis diagnosis were assessed. A logistic regression analysis to investigate characteristics contributing to patient mortality was conducted. The predictor variables race and age, in the logistic regression analysis were found to contribute to the model.
Conclusions: We did not find the diagnosis of COVID-19 to be a significant predictor. A better understanding of the role of demographic factors such as race, sex, ethnicity, age, and insurance status as they relate to length of stay, early deaths, mortality rate, discharge status, and discharge location can help healthcare workers improve the quality of their care.