What to Know About Sepsis and COVID-19

Sepsis increases a person’s risk of COVID-19 due to the compromised immune system that results from fighting sepsis. Some complications of COVID-19 and sepsis overlap. Being immunocompromised may lead to more severe health outcomes from COVID-19, including long-term complications.

This article talks about the risks and complications of sepsis and COVID-19, sepsis treatment, and how to stay safe while living with or recovering from sepsis.

Sepsis and COVID-19 Risk

A weakened immune system is a risk factor for both sepsis (the body's extreme, life-threatening response to an infection) and COVID-19. People who have had sepsis are more vulnerable to contracting any infection within a few weeks or months of recovering from sepsis. This includes infection from the SARS-CoV-2 virus that causes COVID-19. Increased risk is due to having a compromised immune system from battling sepsis.

Some health conditions can increase the risk of getting sepsis and COVID-19. For example, people with chronic obstructive pulmonary disease (COPD) have a higher risk of getting lung infections (like pneumonia), which increases the risk of sepsis. This, in turn, increases the risk of COVID-19 due to the lung damage caused by COPD and the compromised immune system.

In addition to the risk of infection with COVID-19, there is also the risk of exposure to COVID-19. Because sepsis is a life-threatening condition, people with sepsis or recovering from sepsis require intense medical care. Being in a healthcare setting puts people with sepsis at higher risk of being exposed to COVID-19. 

Gender may also be at play in sepsis and COVID-19 risk. Studies have found gender differences in response to sepsis. This stems from both biology and sex hormones of individuals.

The X chromosome has a lot of immunocompetent genes (which benefit immunity). In the case of infections, research shows that the sex hormone estrogen has beneficial effects on the immune system.

For example, estrogen has a protective effect against bloodstream infections, which could lead to sepsis. Reduced sepsis risk means reduced COVID-19 risk that may otherwise occur due to a compromised immune system.

Complications of COVID-19 and Sepsis

There is a two-way association between sepsis and COVID-19 (sepsis increases the risk of COVID-19, and vice versa). A significant risk factor for both conditions is a compromised immune system.

People with weakened immunity are more likely to get infections, including viral ones like COVID-19. And people with compromised immune systems are more likely to have severe COVID-19. Septic shock, the most severe consequence of sepsis, is a complication of critical cases of COVID-19, though those are rare.

While bacterial infections are the leading cause of sepsis, viruses, such as SARS-CoV-2, can also lead to sepsis. COVID-19 and sepsis share complications, including hypoxia (low oxygen levels), chronic renal failure, and coronary heart disease.

Abnormal blood clotting associated with sepsis may also occur in severe cases of COVID-19. One study of people with COVID-19 in Wuhan, China, found that sepsis was the most common complication. However, this may not always be the case, especially with different variants and levels of immunity.

A compromised immune system following sepsis could increase the risk of long-term COVID-19 complications as immune system dysregulation (which occurs when the body can't control or prevent an immune response) may lead to long-term COVID-19 infection, also known as long COVID. This highlights the importance of prevention and treatment of COVID-19 to reduce the risk of living with long-term complications.

Sepsis Treatment and COVID-19

Because sepsis is a severe condition, treatment takes place in a hospital, usually in the intensive care unit (ICU). While this is necessary, it does impact COVID-19 risk. Infection prevention is key to reducing that risk.

Antibiotics are usually the first course of treatment for sepsis, as treating the underlying condition is one of the main goals. Ensuring sufficient blood flow to the organs to keep them functioning optimally is also critical. This is even more important if someone with sepsis is at risk of exposure to COVID-19, as hypoxia is a potential complication. 

While COVID-19 is a serious health risk for people with sepsis, the disease has paved a path for greater knowledge about infections, including how to better detect and respond to them.

For example, the COVID-19 pandemic has led to significant improvements in diagnostic technologies, which, in turn, can help healthcare providers identify and focus on treating the causes of sepsis. Ruling out bacterial infections through improved diagnostic tests can reduce the unnecessary use of antibiotics, which contributes to antibiotic resistance, and makes sepsis harder to treat.

As scientists and healthcare providers learn more and more about treating COVID-19, knowledge may be gained about how to treat sepsis from other infections better. 

How to Stay Safe

The CDC recommends the following measures to protect your health and others:

• Get vaccinated and stay up-to-date with COVID-19 vaccines.
• Wear a mask indoors in high-risk areas.
• Keep physical distance with others if you are at higher risk of getting severely sick from COVID-19.
• Don’t go to crowded or poorly ventilated places.
• Test for COVID-19.

While these recommendations apply to everyone, people living with or recovering from sepsis may need to be more vigilant about following them. While very important, vaccines do not guarantee protection for anyone and may be less effective in people with compromised immune systems.

Because a weakened immune system may not respond as well to COVID-19 vaccines, additional protective measures are important for reducing the risk of exposure and infection with COVID-19. For example, wearing a mask, even if up-to-date on vaccines, is recommended for people with weakened immune systems.

Talk to your healthcare provider about what other measures they recommend for keeping you safe, given your unique health status and needs.

Summary

Sepsis increases the risk of contracting COVID-19 due to a compromised immune system from battling the infection that caused sepsis. Also, because sepsis treatment requires hospital care, the risk of exposure to COVID-19 in the healthcare setting is also increased.

Sepsis and COVID-19 have overlapping complications, and sepsis is a complication of COVID-19. COVID-19 mitigation strategies are critical for people living with or recovering from sepsis, especially because of their greater risk of severe illness, long-term complications, and death.

A Word From Verywell

Having sepsis is scary in and of itself without having to worry about COVID-19. A compromised immune system from sepsis is a lot to manage, especially when COVID-19 is in your surroundings or community.

However, prevention is possible. Protecting yourself may take a little extra diligence, but you are not alone. Your healthcare provider or team can help you determine how to best manage your health, given the risks, and keep you healthy as you recover and your immune system gets stronger.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.