Q&A on COVID-19 and Sepsis – Submit Your Questions Now
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The Global Sepsis Alliance is the largest professional network on sepsis worldwide, with over 100 member organizations from all parts of the world. After two articles explaining how COVID-19 can cause sepsis, we want to put our network and resources to further good use.

That is why over the last two weeks, we have assembled an international task force consisting of medical professionals, communications experts, and sepsis survivors from all over the world, standing by to answer your most burning questions on COVID-19, especially focused on the relationship between COVID-19 and sepsis.

Please send us your questions via social media (Twitter / Instagram / Facebook), either as a private message or publicly, or submit them via the form below. If you send them publicly via social media, please include the hashtag #askWorldSepsisDay so we can find them.

The most asked questions will be published and answered in the Q&A section of our new COVID-19 information page. Please note that your questions will not necessarily be answered via email - in fact, you don’t need to provide your email address if you don’t want to.

We are looking forward to hearing from you and answering your questions!



Marvin Zick
Life After Sepsis - Free Downloadable Brochure Addressing Life After Sepsis and Post-Sepsis Symptoms for Sepsis Survivors and Their Loved Ones
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Today, we are very happy to release the “Life After Sepsis”-Guide - a free downloadable brochure that aims at guiding survivors and their families, who are the most vulnerable when sepsis occurs.

It wants to inform the general public, patients, their relatives, and healthcare professionals about sepsis. The brochure explains that there is a need for an urgent response due to the consequences of sepsis, including lifelong disabilities. It is not intended to be a substitute for medical advice, but rather to ensure that more people are better equipped to recognize sepsis, prevent it, and cope with its long-lasting effects.

As always, we are looking forward to hearing your feedback, including suggestions for improvements or a typo we overlooked.

Download Life After Sepsis Brochure (PDF)
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Donate to Support the Development of Free Resources
Marvin Zick
Update: Can COVID-19 Cause Sepsis? Explaining the Relationship Between the Coronavirus Disease and Sepsis
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The rapid global spread of the novel coronavirus SARS-CoV-2 has caused societal, economic, and medical upheaval not seen since the 1918 influenza pandemic. As of April 7th, the World Health Organization has confirmed cases in 203 countries, areas or territories, with over 1.2 million confirmed cases and over 65,000 deaths.  Further, many experts believe these numbers to be a gross underestimate for a variety of reasons, including inadequate testing capacity and suboptimal reporting of cases. Despite extensive modeling by epidemiologists all over the world, it is not possible to accurately predict the course and duration of this pandemic. It is important that we continue to obtain objective data on which we base recommendations. A calm and rational approach from both society and individuals is necessary during these uncertain times.

There remains considerable confusion regarding the differences between seasonal influenza and COVID-19 (the illness caused by SARS-CoV-2). While both viruses are capable of causing severe illness and can spread rapidly, it appears that SARS-CoV-2 is a more deadly pathogen on a case-by-case basis, can be spread during the asymptomatic phase, and is capable of much more rapid spread. The higher burden and mortality may be attributed to the fact that SARS-CoV-2 is a “newly emerged” virus, and consequently, there is very little innate immunity to it among humans, unlike with influenza where both prior infection and annual vaccination can provide protection. Overall, however, the sheer contagiousness of this new virus has led to the high morbidity and mortality seen globally – simply put, healthcare systems have been unable to cope with the number of infected persons seeking care. Indeed, a proportion of the reported deaths are due to overwhelmed medical systems rather than the virulence of COVID-19. This is a crucial factor explaining the “flatten the curve” strategy adopted by many countries. 

Now that more scientific data are available on COVID-19, the Global Sepsis Alliance can more definitively state that COVID-19 does indeed cause sepsis. Sepsis is “a life-threatening organ dysfunction caused by a dysregulated host response to infection.” In the case of COVID-19, the effects on the respiratory system are well-known, with most people requiring hospital admission developing pneumonia of varying severity; however, virtually all other organ systems can be affected. This is consistent with a combination of direct viral invasion and sepsis. For example, in a recently published case series of severe COVID-19 cases from the Seattle area in the United States, over 30% had evidence of liver injury and 75% had evidence of a depressed immune response1; another series from the same region reported acute kidney failure in almost 20% of affected patients requiring ICU care 2, and both series reported septic shock severe enough to require drugs to support the heart and circulation in almost 70% of patients. A recent study from China reported that in patients hospitalized with COVID-19, 28% had evidence of significant heart damage (potentially from direct invasion of cardiac muscle by the virus), resulting in heart failure and abnormal heart rhythms – this damage was associated with a five-fold increase in the risk of death3. As there are no proven therapies effective against the virus itself, it is apparent that the best COVID-19 care includes good sepsis care.

Effective and safe treatments for COVID-19 are urgently being sought by scientists across the world. Although it is hoped that the first batches of a COVID-19 vaccine will begin to be tested in humans in April 20204, large-scale distribution of a viable vaccine may still be a year or more away. Treatment trials are underway with antiviral agents such as Lopinavir/ritonavir (LPV/r), Hydroxychloroquine (HCG), Hydroxychloroquine plus azithromycin, Favipiravir (FPV), Remdesivir (RDV), and with immunomodulators such as Tocilizumab, the anti-C5a antibody IFX-1, and Intravenous Immunoglobulin (IVIG). In addition, potential treatment with convalescent serum is being attempted and trialed.

However, despite these efforts, presently there are no specific treatments for COVID-19. As such, the Global Sepsis Alliance continues to strongly advocate for strict adherence to the basic protective measures recommended by the WHO – handwashing, maintaining social distancing, avoiding touching one’s face, practicing proper respiratory hygiene, staying at home if feeling unwell, and obtaining prompt medical care if fever, cough, and breathing difficulty develop together. We also recommend close attention and adherence to the restrictions on social gatherings set by local health authorities and government bodies. We encourage you to assess the particular challenges faced by the healthcare systems in your area, and if you are able to materially assist in any way (including something as simple as volunteering to be a blood donor), please do so. We are in this together. Be safe.

WHO Resources on COVID-19

This article was published on April 7th, 2020, with the most recent data from the WHO Situation Report from April 6th, 2020 - we expect both cases and deaths to rise further. The views in this news post are not intended or implied to be a substitute for professional medical advice. Special thanks to Nathan Nielsen, Niranjan ‘Tex’ Kissoon, Konrad Reinhart, Dennis Kredler, Mahawi Aljuaid, and Simon Finfer for helping to put this article together.


References

1 (Bhatraju PK, et al. NEJM 2020)
2 (Arentz M, et al. JAMA 2020)
3 (Guo T, et al. JAMA 2020)
4 https://time.com/5790545/first-COVID-19-vaccine/

Marvin Zick
Understanding Sepsis – a Film About Sepsis for Young People by the Swedish Sepsisfonden

Sepsisfonden is a Swedish sepsis trust that started in 2015. Since the start, one of their main objectives has been to increase awareness around sepsis in Sweden.

This spring, they have launched a school project where they target young people in their awareness work, especially kids in the ages around 13 to 17. The first step has been producing a film that explains how the immune system works and what happens when you develop sepsis, embedded above.

Later this year, they will also send out a pedagogical material to all science teachers, teaching in year 8 (kids around 14 years), together with this film, and encourage them to take the time to talk about sepsis in class.

Sepsisfonden website
Video on YouTube
Marvin Zick
Deadline for Applications and Nominations for the 2020 GSA Awards Extended to June 30th, 2020
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Due to the current situation worldwide, the deadline for applications and nominations for the 2020 GSA Awards has been extended to June 30th, 2020. We understand the GSA Awards are not a top priority for anyone right now. However, this can also be an opportunity - sepsis and COVID-19 are closely linked, so an innovative project or initiative on COVID-19 might be eligible for an GSA Award as well…

In any case, please share this call for applications and nominations with your colleagues, friends, and other interested parties, or just nominate aspirational sepsis projects yourself.

The GSA Awards honor major contributions in the fight against sepsis every year and are exclusively and kindly sponsored by the Erin Kay Flatley Memorial Foundation.

The awards are granted in three categories:

  1. Governments and healthcare authorities

  2. Non-Governmental organizations, patient advocate groups, or healthcare provider groups

  3. Individual nominees

In addition to recognition, prestige, and of course a beautiful trophy, winners of category 2 and 3 are awarded $ 2,500 each.

If you are having technical troubles, any questions, or feedback on the application process, please contact us.

Contact Us
Marvin Zick
Video Recap from the 3rd Annual Meeting of the European Sepsis Alliance Now Available

The video from the 3rd Annual Meeting of the European Sepsis Alliance is now available to watch on demand - embedded above. Please use the chapter markers (available in the description box on YouTube) to go directly to the speaker/debate you are interested in most.

Over the course of about 3 hours, we heard presentations from sepsis survivors, representatives from the European Commission and WHO, patient safety advocates, sepsis researchers, clinicians, and more. Additionally, we had two panel debates, one on the state of national sepsis plans, and one on how to build support for survivors and families.

View Program (PDF)
Donate to support the fight against sepsis in Europe

The European Sepsis Alliance was founded under the patronage of the European Commissioner for Health and Food Safety, Vytenis Andriukaitis, at our event “Sepsis - A Call to EU Action” in March 2018 and is one of the regional sepsis alliances of the Global Sepsis Alliance.

Marvin Zick
Join Now - Free Livestream from the 3rd Annual Meeting of the European Sepsis Alliance
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Update March 26th: The recording from the meeting is now available.

Original article:

The free livestream from the 3rd Annual Meeting of the European Sepsis Alliance starts on Monday, March 23rd, 2020, at 13:00 Central European Time.

Join Livestream
View Program (PDF)

Over the course of about 3 hours, we will hear presentations from sepsis survivors, representatives from the European Commission and WHO, patient safety advocates, sepsis researchers, clinicians, and more. Additionally, we will have two panel debates, one on the state of national sepsis plans, and one on how to build support for survivors and families.

The meeting takes place completely online, with all speakers, panelists, and moderators presenting from the comfort and safety of their own homes or offices. As a participant, you can join from wherever you have an internet connection, including asking live questions to the speakers and panelists.

The European Sepsis Alliance was founded under the patronage of the European Commissioner for Health and Food Safety, Vytenis Andriukaitis, at our event “Sepsis - A Call to EU Action” in March 2018 and is one of the regional sepsis alliances of the Global Sepsis Alliance.

Marvin Zick
Hadley’s Sepsis Story – Casting Down Her Rae's of Sunshine

Hadley Rae was the sweetest little baby you could ever meet. She would light up the room with her laugh and smile from the day she was born. Our beautiful “Haddie” provided 8 months and 13 days of joy, love, smiles, and sunshine to her family and two big sisters.

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She had her occasional colds and low-grade fever that seemed typical of teething or her building up an immune system. My husband and I would take her to the doctor numerous times throughout her time here and it was always something small like this.

Until 2 weeks before she died, we could tell Hadley was very sick. High fever, cough, congestion, phlegm, and very sleepy. Her older sister and I had the flu the week prior. We tested positive and recuperated quickly.

On March 11th, my husband took her to the pediatrician we have seen multiple times. They did not test her for the flu. Assuming that she had the flu – like her mother and big sister – she was given Tamiflu and sent home to rest. No tests were done.

Within a week later, she was back to feeling much better and fever-free. She went back to daycare for two days. On that second day, March 19th, I dropped Hadley off and I said “I love you Haddie. See you soon!”. She gave me the biggest smile ever.

Right before her nap that day, she was playing on the floor and fell asleep sitting up. She had a bottle and fell asleep again while eating.

Hadley was found unresponsive that afternoon when she was taking her last nap. Paramedics/firefighters rushed to try and revive her on the way to Cook’s Children’s emergency room in Fort Worth, Texas, USA. She was brought back on the way to the hospital, but her blood pressure and vitals were too low.

My husband and I rushed to the emergency room after that phone call of “Hadley is not breathing…” from daycare. We watched the medical team at the hospital do everything in their power to bring her back...It didn’t make any sense to us. We pleaded and begged for our baby to come back to us – she seemed so healthy days and hours before…

An hour after the firefighters and paramedics arrived on scene and the medical team worked on her, she was pronounced deceased – with no known cause of dead at the time.

Two months later, we obtained a copy of her autopsy report – Klebsiella oxytoca sepsis. What in the world was that?!

Officials at Tarrant County Public Health in Fort Worth report that Klebsiella oxytoca sepsis is a systemic response to an infection that can lead to organ failure and death. On its own, Klebsiella oxytoca is found in the intestine and is considered healthy – but when it leaves the intestinal tract, a severe infection can develop.

Even though we have an “answer” from her medical report, I can’t help but to think if only there were more tests done along the way. If only they ran a CBC. Perhaps, we could have helped her in time. Our family wishes that this would be known and added to some protocol for children. Children cannot always tell us how they really feel. Awareness and advocacy for sepsis need to be brought to the world’s attention now – it may save your loved one’s life one day.

My family does know this, we want to keep spreading her “Rae’s” of sunshine across the world. In memory of Hadley, we have started random acts of kindness, big or small in memory of Hadley Rae Fowler.

We hope Hadley’s “Rae” reaches the masses. Today, March 19th, 2020, is the first anniversary of her death and will be the first annual “Hadley “Rae” Day”. We will use this day especially to spread her sunshine.

Please visit Hadley’s Facebook page and use #hadleysraeofsunshine to share your kindness in memory of our daughter.

Hadley's Facebook Page
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The article above was written by Emily Fowler, Hadley’s mother, and is shared here with her explicit consent. The views in the article do not necessarily represent those of the Global Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice. The whole team here at the GSA and World Sepsis Day wishes to thank Emily for sharing her daughter’s story and for fighting to raise awareness for sepsis.


Marvin Zick