News: Divisions emerge over new ‘viral sepsis’ clinical definition at recent conference

A heated debate is under way regarding how to properly categorize “viral sepsis,” according to MedScape.

This debate was on full display at the recent 2025 European Respiratory Society (ERS) Congress and centered around whether “viral sepsis” should be considered “a distinct clinical threat that demands specific recognition,” or whether such a designation was a “dangerously ambiguous term that risks misattributing symptoms and delaying life-saving antibiotics.”

At ERS, while there were intense areas of disagreement, there were also areas of common consensus. For instance, according to MedScape, “[n]o one disputed that a virus can cause sepsis, a life-threatening organ dysfunction that arises when the body has a dysregulated response to infection.”

However, whether the virus is a “cause or consequence of [an] illness” remained “unclear.”

On the one hand, researchers like Joseph P. Mizgerd, ScD, professor of medicine and virology at Boston University Chobanian and Avedisian School of Medicine, argued that successful antiviral treatments—like, for instance, a recent systematic review of more than 1.2 million patients with COVID-19—demonstrated “proof of causality.”

“This really suggests that the antiviral therapies are helpful and that the viruses are causing [the sepsis], not just [acting as] consequences,” he told MedScape.

On the other hand, some physicians raised concerns about the “clinical utility” of creating a “viral sepsis” term. For instance, Karl Hagman, MD, senior consultant in infectious diseases at the University of Gothenburg, Gothenburg, Sweden, raised a number of concerns, such as:

• Diagnostic criteria (e.g., sequential organ failure assessments for sepsis do not include infections)
• Defining and determining dysregulated host responses
• Clinical relevance of the term (e.g., the term would group together “vastly different” infections)
• Misattribution leading to ineffective treatment

Editor’s note: To read the MedScape coverage, click here.