CHEST Guidelines-Coronavirus-Disease-2019-Sepsis_2020

Coronavirus-Disease-2019-Sepsis_2020_chest

Pdf Summary

The document discusses the connection between COVID-19 and sepsis, emphasizing the impact of antimicrobial stewardship. COVID-19, caused by SARS-CoV-2, leads to sepsis characterized by life-threatening organ dysfunction, similar to bacterial sepsis but without highly effective antimicrobial therapies. COVID-19 patients often experience severe symptoms like multiorgan failure, comparable to those of bacterial infections. However, the current antiviral treatments, such as remdesivir, only shorten illness duration but do not significantly reduce mortality, leaving care primarily supportive.<br /><br />The authors, Angel O. Coz Yataco and Steven Q. Simpson, highlight historical comparisons, noting that before antibiotics, infections like pneumococcal pneumonia had extremely high fatality rates. They stress that COVID-19 provides insight into a possible future where antimicrobial resistance renders treatments ineffective, suggesting parallels with pre-antibiotic eras. They cite rising drug-resistant infections, such as Candida auris and extended-spectrum beta-lactamase organisms, underlining the severe threat posed by antimicrobial resistance.<br /><br />The article advocates for intensified antibiotic stewardship practices to control bacterial and fungal infections better. It underscores the importance of infection control and continuing to provide evidence-based treatments for resistant organisms. Improving survival rates for critically ill COVID-19 patients depend on advancements in supportive care technologies and methodologies.<br /><br />Lastly, the piece calls for prioritization of randomized controlled trials to explore effective treatments for COVID-19-related sepsis, stressing the need for more than supportive care as the pandemic continues. It serves as a prompt for the healthcare system to prepare for future pandemics by ensuring effective infection control measures and maintaining robust antibiotic stewardship.

Keywords

COVID-19

sepsis

antimicrobial stewardship

SARS-CoV-2

antiviral treatments

antimicrobial resistance

infection control

Candida auris

supportive care

randomized controlled trials