Abstract 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 postinfectious sequelae 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 ARF, such as high-flow nasal oxygen and awake prone position, have already been incorporated in standard-of-care sepsis management. Last, postinfectious sequelae present equally after sepsis (postsepsis syndrome [PSS]) and COVID-19 (post-COVID-19 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.
V. Petrakis, D. Toumpanakis, E. Kyriazopoulou· Seminars in Respiratory and...· 0 citations
AIM
To compare the burden and severe outcomes among patients hospitalised for influenza to those hospitalised for coronavirus disease 2019 (COVID-19) in Greece.
METHODS
The study was conducted in four hospitals from November 2024 to May 2025. Main outcomes were length of stay (LOS) and severe outcomes (admission to intensive care unit, invasive mechanical ventilation, in-hospital death). The associations between LOS and adverse outcomes with COVID-19 or influenza were estimated with multivariable negative binomial and logistic regression models.
RESULTS
We studied 621 patients [mean age: 75.6 years; 564 (90.8%) with at least one comorbidity], of whom 43 (6.9%) died. In total, 358 patients were admitted for COVID-19 and 263 for influenza. Influenza patients had a mean LOS of 10.7 days compared with 7.5 days among COVID-19 patients (p-value <0.001), while severe outcomes were similar across the two groups. Adjusted models yielded similar findings, with influenza patients having significantly longer LOS [incidence rate ratio (IRR): 1.47; 95% confidence interval (CI): 1.03-2.10] compared with COVID-19 patients, and no difference in the odds of experiencing any severe outcome [adjusted odds ratio (aOR) = 2.10; 95% CI: 0.88-5.04]. Pneumonia was associated with increased odds for any severe outcome (aOR: 7.55; 95% CI: 1.10-52.33) and longer LOS (IRR: 2.09; 95% CI: 1.39-3.15) overall and within diagnostic subgroups. Among COVID-19 patients, those with ≥1 COVID-19 vaccine dose had reduced odds for experiencing any severe outcome (aOR = 0.38; 95% CI: 0.15-0.96) compared with unvaccinated patients.
CONCLUSIONS
In 2024-2025, influenza patients had significantly longer LOS than COVID-19 patients, while severe outcomes were not significantly different between the two groups.
H. Maltezou, V. Rapti, Ilektra Tseliou et al.· Infectious Diseases· 0 citations
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