Participants recruitment

Following the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), patients exhibiting systemic signs of infection and a Sequential Organ Failure Assessment (SOFA) (originally the Sepsis-related Organ Failure Assessment) score of 2 or higher were classified as having sepsis [19]. Blood samples were collected upon enrollment into the study, and clinical data were recorded through the Hospital Information System (HIS). The SOFA score is composed of scores from six organ systems (respiratory, renal, hepatic, cardiovascular, coagulation and neurologic) graded from 0 to 4. If the score exceeds two points, it signifies organ injury. Exclusion criteria encompassed individuals under the age of 18, pregnant individuals, those with end-stage organ failure, and individuals with terminal illness. During hospitalization, if patients experienced worsening organ dysfunction indicated by a change in baseline of the total SOFA score of 2 points or more, or the occurrence of new complications such as acute respiratory distress syndrome (ARDS), septic shock, disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome (MODS) or death, we categorized them as having deterioration of sepsis. Finally, 43 patients with sepsis were recruited from our ICU, along with 20 healthy donors from the Health Examination Center of the affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University during December 2022 to October 2023. The study was approved by the Ethics Committee of the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, and informed consent was obtained from each participant, in adherence to the principles outlined in the Helsinki Declaration.