Sepsis patient representative and coordinator of 'Sepsis en daarna': Idelette Nutma

“I went to the ER, was admitted to the hospital with pneumonia and two hours later, I suddenly felt very dizzy. I was going into shock”,  Idelette Nutma tells us. She was quickly transferred to the ICU. ‘That rapid response was crucial, it saved my life’. Sepsis is very dangerous and a lot of people aren’t aware of that, including professionals. Yearly, fifty million people worldwide develop sepsis and twenty percent do not survive. But what is sepsis and why is there so little known about it? In this article, we speak with Idelette Nutma, former sepsis patient, patient representative, and coordinator of ‘Sepsis en daarna’.

How does sepsis arise?

Sepsis is an acute and derailed inflammation caused by, for example, a virus, bacteria, or parasite. When such foreign, harmful organisms enter the body or the bloodstream, an inflammatory response is activated to neutralize the infection. However, in the case of sepsis, the immune-response is overacting and actually harming the body's own tissues and organs. Several complex cellular and molecular events take place and different symptoms arise. The first symptoms are often fever and chills, rapid breathing, increased heart rate, insufficient blood flow, and drowsiness. Early diagnosis and recognition of these symptoms are crucial for the survival of the patient.

What is the importance of raising awareness of sepsis?

Someone who develops sepsis will most likely be sent to the ICU. A lot of care is needed and many people are involved, like ambulance and emergency staff, nurses, and intensivists. Early recognition is important for the survival of the patients and it also helps to reduce the workload and length of stay on the IC. Raising sepsis awareness will lead to patients and professionals recognizing the symptoms earlier before the condition becomes life-threatening or fatal.

Discharged from the hospital, what happens next?

Sepsis is an acute illness with an impact that goes far beyond hospital admission. It can leave patients with organ dysfunction or even loss of hands, arms, legs or feet due to blood clotting. The majority of patients who are discharged from the hospital develop new and long-lasting symptoms at a later stage like neurocognitive sequelae, disabling muscle,  joint or nerve pains, and tiredness. Some people also experience a decrease in mental function. They develop symptoms like insomnia, panic attacks, and some lose self-esteem and self-belief.  Still little is known about the symptoms, causes, and solutions, and too little aftercare is provided, Idelette explains. This needs to change.

Why is sepsis such an unknown disease?

Time is essential and to save lives we need to educate people about what sepsis is and what symptoms to look out for. “In the Netherlands, people do not know the term ‘sepsis’ and find it a heavy and difficult medical term”, Idelette tells us. In other countries, however, there is a lot more awareness of the condition. More and bigger organizations are busy spreading the word about sepsis, like the Global Sepsis Alliance and the European society of intensive care medicine (ESICM). It is important that sepsis awareness is increased in all countries around the world.

COVID-19 and sepsis

Many people do not know that a coronavirus infection can lead to sepsis. COVID-19 is an acute inflammatory disease like sepsis, but not all coronavirus infections will lead to sepsis. Most of the time it is only the severe cases of COVID-19 that lead to sepsis.

What are the similarities between COVID-19 and sepsis?

Acute cases of COVID-19 can lead to sepsis with high mortality. However, non-acute COVID-19 can also have similarities with sepsis. Sometimes, due to the coronavirus infection  the inflammatory reactions in the brain persist and keep going. This causes symptoms like  chronic fatigue  as part of post COVID as well as post sepsis syndrome.. Symptoms like heart palpitations,and the nervous system being affected, occur in both long COVID and sepsis. For both diseases, aftercare is very important and often not taken seriously enough. The long-lasting symptoms in both cases are almost invisible. But they are there, and they need to receive more attention.

What are the differences between COVID-19 and sepsis?

COVID-19 arises from the coronavirus and sepsis can be a result of any type of infection, like a virus, a bacteria, or even organ transplantation. Both conditions have a different impact on the body. While the coronavirus first affects the lungs in most cases, sepsis can also start with dysfunctioning ofthe brain, especially in elderly people. When the brain is affected first, the symptoms are not always easy to recognize. This is the reason people don’t always know they suffer from sepsis. Symptoms related to COVID-19 are, in most cases, easier to recognize.

What do we do?

A lot of people don’t know the consequences of sepsis. Working on sepsis awareness among the population and among professionals is therefore very important. Especially for the early recognition of the disease and the aftercare for the patients. As the SensUs Organization, we organize an annual international student competition in the field of biosensing, with a different theme every year. Last year, the theme was influenza A and this year the theme is acute inflammation with a focus on sepsis. Students from all over the world design the best possible biosensor to detect sepsis. And we all have the same goal: improve healthcare, save lives, and raise sepsis awareness!