# P-1588. Impact of the COVID-19 Pandemic on Sepsis due to Serratia: Trends in Incidence, Mortality, and Hospital Resource Utilization — A National Inpatient Sample Analysis (2016–2022)

## TL;DR

The study found that sepsis caused by Serratia bacteria increased in incidence and mortality during the COVID-19 pandemic, with higher healthcare costs and longer hospital stays.

## Contribution

This paper is the first to analyze national trends in Serratia sepsis incidence, mortality, and healthcare utilization before and during the COVID-19 pandemic.

## Key findings

- The incidence of Serratia sepsis increased from 13.7 to 21.0 per 100,000 hospitalizations between 2016 and 2022.
- Mortality from Serratia sepsis rose significantly during the pandemic, peaking at 3.34 per 100,000 in 2021.
- Patients co-infected with Serratia and COVID-19 had higher mortality, longer hospital stays, and higher charges.

## Abstract

Serratia species are emerging causes of healthcare-associated sepsis, with growing concerns about antimicrobial resistance and high mortality. The influence of the coronavirus disease 2019 (COVID-19) pandemic on national trends of incidence, outcomes, and healthcare utilization in sepsis due to Serratia remains unclear.Table 1:Baseline characteristics and outcomes of patients before and during the COVID-19 era (2016–2022)Figure 1:Temporal trends in the incidence and in-hospital mortality of sepsis due to Serratia (2016–2022)

Baseline characteristics and outcomes of patients before and during the COVID-19 era (2016–2022)

Temporal trends in the incidence and in-hospital mortality of sepsis due to Serratia (2016–2022)

We analyzed the National Inpatient Sample (NIS) from 2016 to 2022 to identify adult hospitalizations with sepsis due to Serratia and relevant comorbidities using ICD-10 codes. The study period was stratified into pre-COVID (2016–2019) and post-COVID (2020–2022) groups. Weighted national estimates were used to assess annual incidence and In-hospital mortality per 100,000 hospitalizations. Hospital charges were adjusted for inflation using the Medical Care Consumer Price Index. Subgroup analysis compared outcomes between COVID-19 co-infected and non-co-infected patients during the post-COVID period. Temporal trends were analyzed using linear regression. Categorical variables were compared using Chi-square or Fisher's exact test, and continuous variables using t-tests or analysis of variance.

Among 43,595 sepsis due to Serratia hospitalizations, incidence rose from 13.7/100,000 (2016) to 21.0/100,000 (2022; peak 22.1 in 2021, p=0.0007). Mortality increased from 1.44/100,000 pre-COVID to 2.92/100,000 post-COVID (peak 3.34, p< 0.001). Post-COVID era had longer length of stay (LOS) (16.2 vs. 15.1 days, p=0.028) and higher charges ($261,748 vs. $234,708, p=0.023). COVID co-infection (8.2%) was linked to higher mortality (36.8% vs. 11.9%, p< 0.001), LOS (29.8 vs. 15.0 days, p< 0.001), and charges ($521,009 vs. $238,640, p< 0.001).

The incidence and mortality of sepsis due to Serratia have significantly increased in the United States during the COVID-19 pandemic, accompanied by greater healthcare resource utilization. These findings highlight the critical need for enhanced infection control and focused strategies to mitigate the burden of sepsis due to Serratia in the post-pandemic era.

All Authors: No reported disclosures