Clinical Outcomes and Hospital Resource Utilization Among Patients with Septic Shock and COVID-19 Infection: Insights from United States National Inpatient Sample Analysis 2020–2022

Authors:
Preprint
Publisher website
Google Scholar
Abstract
Coronavirus disease 2019 (COVID-19) causes a hyperinflammatory state, endothelial injury, microvascular thrombosis and myocardial dysfunction, which may lead to worsening circulatory failure in septic shock. Using a large National Inpatient Sample (NIS) database from 2020 to 2022, we aimed to compare in-hospital mortality, need for mechanical ventilation, acute kidney injury (AKI), need for renal replacement therapy (RRT), cardiac arrest, acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO), tracheostomy, acute liver failure, disseminated intravascular coagulation (DIC), hospital length of stay (LOS), and total hospital charges in septic shock hospitalizations with and without COVID-19. A total of 2,175,619 adult septic shock hospitalizations were identified, of which 378,635 (17.4%) had COVID-19 infection. Hospitalizations with COVID-19 had significantly higher mortality (60.3% vs. 32.2%; aOR 3.43, 95% CI 3.35–3.50), increased need for non-invasive ventilation, invasive ventilation, and higher incidence of AKI, RRT, cardiac arrest, ARDS, ECMO use, and tracheostomy. Additionally, hospital LOS and total hospital charges were also significantly higher in hospitalizations with COVID-19. There was no significant difference in acute liver failure or DIC. In conclusion, COVID-19 infection was independently associated with worse outcomes and increased hospital resource utilization in adult septic shock hospitalizations.

This publication has 28 references indexed in Scilit: