Post-Sepsis Syndrome: From Pathogenesis Toward Novel Management Strategies

Sepsis survivorship is increasing, but many survivors develop post-sepsis syndrome, marked by high early readmission rates and new-onset conditions, notably recurrent infections, cardiovascular, psychiatric, and kidney disease. Persistent physical, cognitive, and psychological sequelae may further impair daily functioning. Emerging evidence suggests lasting immune dysregulation, likely interacting with mitochondrial dysfunction, immunosuppression, endothelial injury, low-grade inflammation, and microbiome disruption. While evidence for targeted postdischarge interventions remains limited and yields mixed results, much can still be done. Several strategies can begin during hospitalization, and after discharge a primary-care-centered, risk-stratified follow-up pathway may support recovery and reduce readmissions and complications.