b'COVID-19,COBALAMIN / B12, AND SEPSIS:A Left-of-Field SolutionBY DR. CARMEN WHEATLEYSt Catherines College, Oxford, & UK Reg. Charity, 1078066, Survive Cancer.Imedicinevaccines, antibiotics,Causes latter being a more acceleratedYou Need to Know the of n spite of all of the advances of mod-ernSepsis, which includes septic and toxicSymptomsantivirals, antifungals, and intensiveshock (theUnfortunately, the initial symptoms caresupportnevertheless,world- version of sepsis), may have multiple overtsepsis are very general and non-specific. wide,sepsisremainstheprimarycausecauses: trauma; surgery; kidney and oth- Nonetheless, sepsis should always be sus-ofdeathfrominfections,whetherbacte- er organ failure; burns; smoke inhalation;pected when someone suddenly becomes rial, viral or parasitic. Moreover, the inci- obvious immune vulnerability, as in HIV/ confused, even perhaps mentally disturbed dence of sepsis is doubling every decade.AIDS, advanced cancers and tuberculosis;and hallucinating; if there is unexplained Infants,particularlyprematureinfants,malaria, particularly cerebral malaria; eb- shivering,withnotablycoldextremities; theelderly,cancerpatientsandtheim- ola; meningitis; pneumonia; urinary tracttogether with enlarged lymph glands; an mune-compromised,blacks,andobeseinfections;wounds,evenpinpricks;im- unusually low, or high, temperature; fail-people are most at risk for sepsis. With theplantedmedicaldevices;cellulitis;poorure to urinate in a day; unusual and severe exception of infants, these are pretty muchdental health or dental procedures; tattoosbreathlessness, a feeling of doom, and dis-the very same groups of people currentlyand body piercings; animal bites; appen- colored or mottled skin, with or without dying of COVID-19. dicitis; peritonitis, perforated bowel; preg- any distinctive rash. Yet, sepsis is no respecter of persons.nancy/childbirth;gallstonesandkidneyAny of these symptoms, or any com-There is at times a seeming randomness instones; spleen removal; molds or fungi; vi- bination of these symptoms, in a child or the victims it takes. Youth, privilege, andruses, as in flu, and the known killer flus,adult, is a justifiable cause for an urgent fitness are, at first sight, not necessarily aavian and swine flu; many of the now no- visit to the Emergency Room. It is better to protection.Olympianathletes,Braziliantoriousantibiotic-resistantbacteria,suchbe safe than sorry when it comes to sepsis, models, rock stars, young actors, and ce- as E. coli, staphylococcus aureus, klebsiellabecause time is never on your side.lebritieshavediedofsepsis,oftensud- pneumoniae, clostridium difficile, pseudo-denly and unexpectedly. Think of Socratesmonas,streptococci,listeria,salmonella, the soccer player, George Michael, Princemay all trigger sepsis. And, of course, more RainierofMonaco,AmyPurdy,Pattylatterly, the SARS-CoV-2 virus/COVID-19.Duke,MuhammadAli,andChristopher Cazenove.COVID-19 too has sometimes claimed the most unexpected victims.Is there sense and a connecting thread behind the apparent occasional random-ness of sepsis and of COVID-19 mortalityTo Save a Life, Time Isamongst the seeming well? of the Essence To try and answer this leading ques- Mortality from sepsis can range up to tion, we must first understand what sepsis50% or higher, depending on the hospital, entails. and the chances of dying increase by 8% H ealtHF reedomN ews /F all2020 13HFN_FALL-2020_11-02-2020-FINAL.indd 13 11/2/20 8:50 PM'