Health UK (Commonwealth Union) – Researchers from The University of Manchester have discovered that individuals belonging to the most socioeconomically deprived groups are nearly twice as likely to succumb to sepsis within 30 days. The extensive study, funded by the UK Health Security Agency, Health Data Research UK, and the National Institute for Health and Care Research Manchester Biomedical Research Centre, analyzed 248,767 cases of non-COVID-19 sepsis from January 2019 to June 2022, compared with 1,346,166 controls. The findings, recently published in the journal eClinicalMedicine, also highlighted that individuals with learning disabilities were almost four times more likely to contract the life-threatening illness.
Furthermore, the study revealed elevated risks for specific health conditions, such as chronic liver disease (over 3 times more likely), chronic kidney disease stage 5 (over 6 times more likely), cancer, neurological disease, immunosuppressive conditions, and a history of multiple antibiotic courses, all associated with the development of non-COVID-19 sepsis.
Sepsis, a condition where the body’s immune system excessively responds to an infection, leading to an attack on its own tissues and organs, is a major contributor to global mortality. Symptoms, resembling those of flu, include severe breathlessness and a high fever, with approximately 80% of cases originating outside hospitals in the UK.
This study uniquely examines the variations in non-COVID-19 sepsis incidence before, during, and after the COVID-19 pandemic within a large population. Notably, the research indicates a decrease in the incidence rate of non-COVID-19 sepsis during the pandemic, attributed by the authors to reduced social mixing and changes in healthcare delivery. However, the figures rebounded to pre-pandemic levels in April 2021 after the national lockdowns were lifted.
Co-author Professor Tjeerd van Staa from The University of Manchester indicated, that this study demonstrates that socioeconomic deprivation, comorbidity, and learning disabilities are associated with an increased risk of developing non-COVID-19 related sepsis and 30-day mortality in England. Professor Tjeerd van Staa further indicated that he believes the research offers comprehensive data and findings relevant to healthcare systems worldwide.
“It underscores the urgent need for sepsis risk prediction models to account for chronic disease status, deprivation status, and learning disabilities, along with infection severity.
“Sepsis remains a global issue of significant concern so understanding its clinical and health inequality risk factors is essential to understanding at-risk cohorts and effective public health mitigations.
Xiaomin Zhong, a PhD researcher at The University of Manchester and co-author, expressed uncertainty regarding the reason for the increased risk of sepsis in patients exposed to multiple courses of antibiotics.
He further indicated that the adverse effects of antibiotics on beneficial gut bacteria might contribute to heightened susceptibility to infection, although the exact mechanism remains unclear. Factors such as underlying differences in immune status or comorbidities could also play a role.
Zhong further indicated that given the potential negative consequences of repeated antibiotic courses, there is a critical need to target these medications to patients who would derive the most benefit.
Professor van Staa emphasized the importance of leveraging this knowledge to enhance healthcare systems’ preparedness for future pandemics or global health crises. This approach aims to prevent disproportionate impacts on vulnerable groups and maintain or improve the overall quality of care.
He further indicated that nevertheless, it is essential to recognize that these findings are primarily descriptive, underscoring the necessity for further research to establish causality and guide the development of effective prevention and treatment strategies for sepsis.
UKST Founder and Joint CEO Dr Ron Daniels says “As an intensive care doctor in inner-city Birmingham, I frequently see patients from underrepresented communities presenting late with sepsis. This important study reminds us that socioeconomic status and the presence of underlying illness – which are themselves often interlinked and additionally linked to ethnicity – are at play in determining inequality in the risk of developing non-Covid sepsis. Healthcare has a duty to reduce this inequality and improve access for all.
