Construction of a sepsis recovery-failure axis and single-cell anchoring using public multi-cohort whole-blood and single-cell transcriptomic data

Researchers constructed a novel sepsis recovery-failure axis using transcriptomic data analysis from multiple patient cohorts. They identified 20 recovery-related genes and 20 failure-related genes, which formed the basis for a recovery-failure score. Survivors showed upward movement along this axis by day 5, while non-survivors progressively shifted toward failure with clear separation by day 5. The score was transferable across different cohorts and remained independent of neutrophil proportion and baseline APACHE II score. At the single-cell level, the strongest signals were found in classical monocytes, which in non-survivors showed reduced interferon responses and altered inflammatory processes. The researchers concluded that this axis may support sepsis state stratification and disease-course monitoring, but requires prospective calibration before clinical use in individual patients.