THE COVID-19 PANDEMIC AND THE IMPORTANCE OF EARLY RECOGNITION OF SEPSIS IN PRE-HOSPITAL EMERGENCY HEALTHCARE. A STUDY FOR FUTURE PERSPECTIVES

In this retrospective, observational study, we evaluated all patients admitted to the 118 SET (territorial emergency system) of SG Moscati Hospital of Taranto City, Italy, between April and November 2020. Data and outcomes obtained from the 313 patients during the early phase of the COVID-19 pandemic showed that the detection of early signs of infection significantly increased the chances of surviving, especially in elderly subjects affected by pre-existing comorbidities. We found that these findings were strongly related to simultaneity and unobserved heterogeneity of conditions, perhaps also due to the poor quality of information on COVID-19 deaths. The interesting point was finding that mild and severe cases of COVID-19 showed significant differences in many aspects. The clinical signs, expression markers of blood gas analysis (ABG), complete blood count (CBC), and inflammatory patterns were evaluated in a non-intensive care setting, both in the ambulance and in the triage of the COVID-19 Unit of SET 118, and which were then used as essential markers to prevent the outcomes of COVID-19 sepsis protocol, called EESS or empirical emergency septic signs. The overall check and screening parameters based on EESS performed on a total of 313 patients gave an accurate picture that finely described the real grade of the infection with corresponding internal damages superior to RT-PCR and thoracic CT scans alone. The collected data made it possible to examine exposures to suspected outcomes, pursue predictive risk factors, and build a precise therapy to be executed starting from the ambulance, which ultimately led 118 SET to rescue the greatest majority of admitted patients, with only 17 deaths (5.4%) out of 313 patients (94.6%; male-207; female-106) in the first seven days of hospitalization.