April 2021

 

 

Sepsis among Patients Hospitalized with COVID-19
PA Health Care Cost

Containment Council This research brief focuses on patients hospitalized with COVID-19 who also had a
diagnosis of sepsis. Sepsis is a life-threatening condition characterized by a system-
wide inflammatory response to infection that can worsen to acute organ dysfunction.

This research brief examines Pennsylvania residents and non-residents of all ages who
were hospitalized with COVID-19 and discharged from a Pennsylvania acute care

cov] D-19 hospital from March through September 2020. As these hospitalizations occurred
during the first seven months of the COVID-19 pandemic, the results form a basis for
Analyses future analysis and comparison as subsequent data becomes available. The results in

this report were not adjusted for age or other patient characteristics to avoid masking
—_——_— = important sociodemographic differences.

 

 

 

There were 26,266 COVID-19 hospitalizations in Pennsylvania between March and September 2020; 30.5% (or
7,998) of these patients also had a diagnosis of sepsis. In general, patients who had COVID-19 and sepsis had
higher in-hospital mortality rates and stayed in the hospital longer, with a higher percentage needing
mechanical ventilation.

The in-hospital mortality rate for patients with COVID-19 and sepsis was 30.5%, compared to
30.5% | 7.6% of patients with COVID-19 who did not have sepsis. Overall, patients hospitalized with
A COVID-19 between March and September had an in-hospital mortality rate of 14.5%.

The average length of stay for patients with COVID-19 and sepsis was 12.5 days, compared to
7.2 days for patients with COVID-19 who did not have sepsis. Overall, patients hospitalized
with COVID-19 stayed in the hospital an average of 8.8 days.

Mechanical ventilation was used in 33.0% of patients with COVID-19 and sepsis, compared to
33.0% | 5.9% of patients with COVID-19 who did not have sepsis. Overall, mechanical ventilation was

I

A used in 14.2% of patients hospitalized with COVID-19.

 

Among patients hospitalized with Rate of Sepsis by Age Category
COVID-19:
e 33.9% of those ages 65-84 had 30.9% 33.9% 31.8%

sepsis, a rate that was statistically
higher than the rate for the rest of
the state.

e 10.4% of those 24 years and
younger and 22.4% of those ages
25-44 had sepsis; both rates were
statistically lower than the rates

 

Age 24 and Age 25-44 Age 45-64 Age 65-84 Age 85 and

for the rest of the state. younger . older
— — —Statewide Rate (30.5%)

 

Pennsylvania Health Care Cost Containment Council
www.phc4.org 1
 

In-Hospital Mortality Rate by Age Category

 

38.7% 40.9% Among patients hospitalized with
COVID-19:
e In-hospital mortality rates were
22.3% higher for those who also had
19.3% sepsis across all age groups.
e In-hospital mortality rates were
10.0% . . .
7.1% highest in patients ages 85 years
0.8% i 3.7% and older and lowest in patients
: t t ages 25-44, for those with sepsis
Age 25-44 Age 45-64 Age 65-84 Age 85 and older as well as those without sepsis.

COVID-19 Stays without Sepsis m@ COVID-19 Stays with Sepsis

1Age 24 and younger are omitted due to low in-hospital mortality volume.

 

. ee 2
Among patients hospitalized with Rate of Sepsis by Race/Ethnicity

COVID-19: 35.1%

e 35.1% of Asian (non-Hispanic)
patients and 32.1% of Black (non-
Hispanic) patients had sepsis; both
rates were statistically higher than
the rates for the rest of the state.

e 26.6% of Hispanic patients had
sepsis, a rate that was statistically Asian Black Hispanic White

lower than the rate for the rest of (non-Hispanic) (non-Hispanic) (non-Hispanic)
the state. — — = Statewide Rate (30.5%)

32.1% 30.8%

   

2Other race/ethnicity groups are omitted due to low volume.

 

In-Hospital Mortality Rate by Race/Ethnicity?

 

 

32.7% Among patients hospitalized with
29.3% -19:
26.8% 95.2% COVID-19:

. e |n-hospital mortality rates were
higher for those who also had
sepsis across all race/ethnicity

9.8% populations.
7.9% . .
5.9% e In-hospital mortality rates were
2.9% highest in White (non-Hispanic)
1 1 1 patients and lowest in Hispanic
Asian Black Hispanic White patients, for those with sepsis as
(non-Hispanic) (non-Hispanic) (non-Hispanic)

well as those without sepsis.
COVID-19 Stays without Sepsis @ COVID-19 Stays with Sepsis

2Other race/ethnicity groups are omitted due to low volume.

Pennsylvania Health Care Cost Containment Council
www.phc4.org 2