Objective This study aimed to elucidate the characteristics of viral sepsis in children by comparing viral and bacterial sepsis.

Methods We conducted a retrospective cohort study in the pediatric intensive care unit (PICU) of a single pediatric hospital. Patients aged <15 years who were admitted for sepsis to the PICU between January 2011 and December 2019 were included. Sepsis was diagnosed according to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) criteria, and the degree of organ dysfunction was evaluated using the Pediatric Sequential Organ Failure Assessment (pSOFA) score. The mortality rate was compared as a primary endpoint between patients with viral sepsis and those with bacterial sepsis.

Results We included 28 patients with viral sepsis and 52 patients with bacterial sepsis. The pSOFA scores for viral and bacterial sepsis were 10 (interquartile range [IQR]: 6.75–14) and 9 (IQR: 7–11) points, respectively, with no significant difference between groups. Respiratory disorders were significantly more prevalent in the viral sepsis group. Mortality between patients with viral (n = 8; 29%) and bacterial (n = 7; 13%) sepsis in the PICU showed no significant difference. When analyses were restricted to patients with septic shock, mortality was significantly higher due to viral (70%) than bacterial (27%) sepsis.

Conclusion In pediatric patients, sepsis due to viral and bacterial infections is associated with similar rates of mortality and organ dysfunction.