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Life
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Current Advances in Diagnosis and Treatment of Sepsis
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Current Advances in Diagnosis and Treatment of Sepsis

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 29 September 2025 | Viewed by 6173

Special Issue Editor

Dr. Chih-Huang Li

E-Mail Website
Guest Editor
Linkou Medical Center, Chang Gung Medical Foundation, Taoyuan, Taiwan
Interests: sepsis; biomarkers; prediction; sepsis treatment; AI models

Special Issue Information

Dear Colleagues,

Welcome to our Special Issue on “Current Advances in Diagnosis and Treatment of Sepsis”, a timely exploration into the innovative diagnostic tools and artificial intelligence (AI) models reshaping sepsis management. Sepsis remains a global health crisis that demands rapid and accurate diagnosis to improve patient outcomes significantly. This issue highlights cutting-edge diagnostic technologies, including rapid biomarker assays and portable point-of-care devices, which represent leaps toward earlier detection and intervention. Equally, we delve into the transformative potential of AI and machine learning in predicting sepsis, analyzing vast datasets to unveil patterns and predictions that surpass traditional methods. Our scope extends to novel treatment strategies, from targeted antimicrobial therapies to immune-modulating techniques, showcasing comprehensive advances in combating this complex condition. We invite researchers and practitioners to contribute insights and findings that propel our understanding and capability in diagnosing and treating sepsis, aiming to foster a multidisciplinary dialogue underpinning future breakthroughs in sepsis care.

Dr. Chih-Huang Li
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sepsis
  • biomarkers
  • prediction
  • immunotherapy
  • AI model

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Published Papers (5 papers)

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Research

11 pages, 540 KiB  
Article
Effectiveness and Safety of Remdesivir for the Treatment of COVID-19 Patients with Liver Cirrhosis: A Retrospective Cohort Study
by Yi-Ching Wong, Chip-Jin Ng, Yan-Bo Huang and Shou-Yen Chen
Life 2025, 15(4), 512; https://doi.org/10.3390/life15040512 - 21 Mar 2025
Viewed by 465
Abstract
Background: Patients with liver cirrhosis are at an increased risk of mortality from coronavirus disease 2019 (COVID-19). Remdesivir, an adenosine analog, exhibits activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is thus recommended for inpatients with COVID-19. This study evaluated the [...] Read more.
Background: Patients with liver cirrhosis are at an increased risk of mortality from coronavirus disease 2019 (COVID-19). Remdesivir, an adenosine analog, exhibits activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is thus recommended for inpatients with COVID-19. This study evaluated the effectiveness and safety of remdesivir in patients with COVID-19 and liver cirrhosis. Methods: This retrospective study was conducted using data from Taiwan’s largest healthcare system. The study cohort comprised adult patients with COVID-19 and liver cirrhosis who visited our emergency department between April 2021 and September 2022. Remdesivir’s adverse effects, including bradycardia, anemia, unstable glucose levels, and abnormal liver function test results, were recorded. Treatment outcomes were assessed in terms of hospitalization duration, mortality, intubation, and intensive care unit admission. Results: This study included 1368 patients with COVID-19 and liver cirrhosis, of whom 46 received remdesivir. Remdesivir recipients were older (66.5 vs. 62 years; p = 0.042) and had a higher rate of oxygen therapy use (56.52% vs. 32.22%; p = 0.001) than nonrecipients. Common adverse effects of remdesivir included lower heart rates (83 vs. 96 bpm; p < 0.001) and decreased hemoglobin levels (9.5 vs. 10.2 g/dL; p = 0.003) without fatal consequences. No statistically significant difference between remdesivir recipients and nonrecipients in hospitalization duration, intubation rates, or mortality rates was found. Conclusions: Remdesivir is safe for treating COVID-19 in patients with liver cirrhosis. Although remdesivir recipients exhibited trends toward improved outcomes in our study, large-scale studies are required to confirm its efficacy in this population. Full article
(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)
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12 pages, 1556 KiB  
Article
Comparative Analysis of the Effectiveness of Generic and Brand-Name Cefepime: A Multicenter Retrospective Cohort Study
by Chih-Huang Li, Peng-Hao Chang, Ching-Tai Huang and Chip-Jin Ng
Life 2025, 15(2), 164; https://doi.org/10.3390/life15020164 - 24 Jan 2025
Viewed by 826
Abstract
The clinical effectiveness of generic and brand-name cefepime in real-world settings remains unclear. Given the potential implications for healthcare costs and patient outcomes, this study aims to compare the efficacy and safety of these two formulations. We conducted a multicenter, retrospective cohort study [...] Read more.
The clinical effectiveness of generic and brand-name cefepime in real-world settings remains unclear. Given the potential implications for healthcare costs and patient outcomes, this study aims to compare the efficacy and safety of these two formulations. We conducted a multicenter, retrospective cohort study (2017–2022), enrolling adults who received either generic or brand-name cefepime as initial monotherapy for at least three consecutive days. Demographics, comorbidities, disease severity, infection sites, cefepime dosage, and serial laboratory data were analyzed. Propensity score matching was employed to adjust key confounding variables. A total of 2370 patients were included, 877 receiving generic and 1493 receiving brand-name cefepime. After matching, no significant differences were observed in primary (in-hospital mortality, p = 0.841) or secondary outcomes (30-day mortality, readmission, length of stay, ICU stay, and incidence of seizures; all p > 0.05). Biomarker trends and clinical recovery patterns were comparable across groups. Receiving the maximal dosage or not did not alter outcomes among both groups. Generic cefepime showed comparable efficacy and safety to brand-name cefepime, offering a cost-effective alternative without compromising therapeutic outcomes. Full article
(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)
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17 pages, 1870 KiB  
Article
Identification of Potential Sepsis Therapeutic Drugs Using a Zebrafish Rapid Screening Approach
by Mark Widder, Chance Carbaugh, William van der Schalie, Ronald Miller, Jr., Linda Brennan, Ashley Moore, Robert Campbell, Kevin Akers, Roseanne Ressner, Monica Martin, Michael Madejczyk, Blair Dancy, Patricia Lee and Charlotte Lanteri
Life 2024, 14(12), 1689; https://doi.org/10.3390/life14121689 - 20 Dec 2024
Viewed by 1172
Abstract
In the military, combat wound infections can progress rapidly to life-threatening sepsis. The discovery of effective small-molecule drugs to prevent and/or treat sepsis is a priority. To identify potential sepsis drug candidates, we used an optimized larval zebrafish model of endotoxicity/sepsis to screen [...] Read more.
In the military, combat wound infections can progress rapidly to life-threatening sepsis. The discovery of effective small-molecule drugs to prevent and/or treat sepsis is a priority. To identify potential sepsis drug candidates, we used an optimized larval zebrafish model of endotoxicity/sepsis to screen commercial libraries of drugs approved by the U.S. Food and Drug Administration (FDA) and other active pharmaceutical ingredients (APIs) known to affect pathways implicated in the initiation and progression of sepsis in humans (i.e., inflammation, mitochondrial dysfunction, coagulation, and apoptosis). We induced endotoxicity in 3- and 5-day post fertilization larval zebrafish (characterized by mortality and tail fin edema (vascular leakage)) by immersion exposure to 60 µg/mL Pseudomonas aeruginosa lipopolysaccharide (LPS) for 24 h, then screened for the rescue potential of 644 selected drugs at 10 µM through simultaneous exposure to LPS. After LPS exposure, we used a neurobehavioral assay (light-dark test) to further evaluate rescue from endotoxicity and to determine possible off-target drug side effects. We identified 29 drugs with > 60% rescue of tail edema and mortality. Three drugs (Ketanserin, Tegaserod, and Brexpiprazole) produced 100% rescue and did not differ from the controls in the light-dark test, suggesting a lack of off-target neurobehavioral effects. Further testing of these three drugs at a nearly 100% lethal concentration of Klebsiella pneumoniae LPS (45 µg/mL) showed 100% rescue from mortality and 88–100% mitigation against tail edema. The success of the three identified drugs in a zebrafish endotoxicity/sepsis model warrants further evaluation in mammalian sepsis models. Full article
(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)
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13 pages, 1214 KiB  
Article
Early Mortality Stratification with Serum Albumin and the Sequential Organ Failure Assessment Score at Emergency Department Admission in Septic Shock Patients
by Sang-Min Kim, Seung-Mok Ryoo, Tae-Gun Shin, You-Hwan Jo, Kyuseok Kim, Tae-Ho Lim, Sung-Phil Chung, Sung-Hyuk Choi, Gil-Joon Suh and Won-Young Kim
Life 2024, 14(10), 1257; https://doi.org/10.3390/life14101257 - 2 Oct 2024
Viewed by 1732
Abstract
Background: Early risk stratification is crucial due to septic patients’ heterogeneity. Serum albumin level may reflect the severity of sepsis and host status. This study aimed to evaluate the prognostic ability of the initial sequential organ failure assessment (SOFA) score alone and combined [...] Read more.
Background: Early risk stratification is crucial due to septic patients’ heterogeneity. Serum albumin level may reflect the severity of sepsis and host status. This study aimed to evaluate the prognostic ability of the initial sequential organ failure assessment (SOFA) score alone and combined with serum albumin levels for predicting 28-day mortality in patients with septic shock. Methods: We conducted an observational study using a prospective, multicenter registry of septic shock patients between October 2015 and May 2022 from 12 emergency departments in the Korean Shock Society and the results were validated by examining those from the septic shock cohort in Asan Medical Center. The primary outcome was 28-day mortality. The area under the receiver operating characteristic (ROC) curve was used to compare the predictive values of SOFA score alone and SOFA score combined with serum albumin level. Results: Among 5805 septic shock patients, 1529 (26.3%) died within 28 days. Mortality increased stepwise with decreasing serum albumin levels (13.6% in albumin ≥3.5, 20.7% in 3.5–3.0, 29.7% in 3.0–2.5, 44.0% in 2.5–2.0, 56.4% in <2.0). The albumin SOFA score was calculated by adding the initial SOFA score to the 4 points assigned for albumin levels. ROC analysis for predicting 28-day mortality showed that the area under the curve for the albumin SOFA score was 0.71 (95% CI 0.70–0.73), which was significantly higher than that of the initial SOFA score alone (0.68, 95% CI: 0.67–0.69). Conclusions: The combination of the initial SOFA score with albumin can improve prognostic accuracy for patients with septic shock, suggesting the albumin SOFA score may be used as an early mortality stratification tool. Full article
(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)
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10 pages, 578 KiB  
Article
The Effectiveness and Safety of Remdesivir Use in COVID-19 Patients with Neutropenia: A Retrospective Cohort Study
by Peng-Huei Liu, Ming-Wei Pan, Yan-Bo Huang, Chip-Jin Ng and Shou-Yen Chen
Life 2024, 14(10), 1252; https://doi.org/10.3390/life14101252 - 1 Oct 2024
Viewed by 1195
Abstract
Background: The COVID-19 pandemic poses severe risks for immunocompromised patients, especially those with neutropenia due to chemotherapy. This study evaluates the safety and effectiveness of remdesivir use in COVID-19 patients with neutropenia. Methods: This retrospective study used the Chang Gung Research Database (CGRD) [...] Read more.
Background: The COVID-19 pandemic poses severe risks for immunocompromised patients, especially those with neutropenia due to chemotherapy. This study evaluates the safety and effectiveness of remdesivir use in COVID-19 patients with neutropenia. Methods: This retrospective study used the Chang Gung Research Database (CGRD) and extracted data from 98,763 patients with COVID-19 diagnosed between April 2021 and September 2022. The patients were divided into groups based on their remdesivir use and the presence of neutropenia. The adverse effects of remdesivir and their outcomes were analyzed after propensity score matching. Results: We compared common adverse effects of remdesivir in neutropenic patients before and after a 5-day regimen. A slight decrease in heart rate was observed but lacked clinical significance. There were no significant differences observed in hemoglobin, liver function tests, and blood glucose levels. After propensity score matching of COVID-19 patients with neutropenia according to gender, age, dexamethasone use, oxygen use, MASCC score, and WHO ordinal scale, no significant differences were found in length of stay, intubation rate, or ICU admission rate between the matched patients. Conclusions: Our study found remdesivir to be safe for COVID-19 patients with neutropenia, with no common adverse reactions observed. However, its effectiveness for these patients remains uncertain. Full article
(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)
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