Teachings from the pandemic

The COVID-19 disease, presenting with complex immune dysregulation and leading to life-threatening organ dysfunction, represents a paradigm of viral sepsis. As heterogeneity of clinical presentation is contained in COVID-19 (one pathogen, one source of infection) related to bacterial sepsis, and due to the urgency of the pandemic for immediate responsive research networks, many trials have been conducted providing beneficial patient outcomes and changing the natural course of disease. In this review, we summarize lessons learnt from the COVID-19 pandemic related to immunotherapy, management of acute respiratory failure (ARF) and post-infectious sequalae that could be implemented in sepsis care. Biomarker-guided immunotherapy in a tailored, precision medicine approach may alter sepsis outcomes. Measures used during the pandemic to handle with ARF such as high flow nasal oxygen and awake prone position have been already incorporated in standard-of-care sepsis management. Last, post-infectious sequalae present equally after sepsis (post-sepsis syndrome-PSS) and COVID-19 (post-covid syndrome-PCS); management of PSS may share details from PCS management and vice versa. Teachings from the pandemic are not limited to the above. Overall, the COVID-19 pandemic has transformed global health to a top priority; focus should remain now active on the sepsis agenda.