Background Up to 11% of critically ill patients with sepsis have an unknown source, where the pathogen and site of infection are unclear. The aim of this scoping review is to document currently reported diagnostic criteria of sepsis of unknown origin (SUO) and identify the types and breadth of existing evidence supporting diagnostic processes to identify the infection source in critically ill patients with suspected SUO. Methods A literature search of Embase, MEDLINE and PubMed for published studies from 1910 to August 19, 2021 addressing the topic of SUO was performed. Study type, country of origin according to World Bank classification, diagnostic criteria of sepsis of unknown origin, and investigative approaches were extracted from the studies. Results From an initial 722 studies, 89 unique publications fulfilled the inclusion and exclusion criteria and were included for full text review. The most common publication type was case report/series 45/89 (51%). Only 10/89 (11%) of studies provided a diagnostic criteria of SUO, but a universally accepted diagnostic criterion was not identified. The included studies discussed 30/89 (34%) history, 23/89 (26%) examination, 57/89 (64%) imaging, microbiology 39/89 (44%), and special tests 32/89 (36%) as part of the diagnostic processes in patients with SUO. Conclusions Universally accepted diagnostic criteria for SUO was not found. Prospective studies on investigative processes in critically ill patients managed as SUO across different healthcare settings are needed to understand the epidemiology and inform the diagnostic criteria required to diagnose SUO.

BACKGROUND The 2019 coronavirus pandemic (COVID-19) has led to increase in global awareness of related public health preventive measures. The public awareness can be reflected by online searching trends of major search engines, namely Google Trends. OBJECTIVE This study aims to interpret online searches of COVID-19 related public health preventive measures and to identify possible correlations between early search trends and progression of the pandemic. METHODS Search data from five queries “Mask”, “Hand Washing”, “Social Distancing”, “Hand Sanitizer”, and “Disinfectant” were extracted from Google Trends (GT) in the form of Relative Search Volumes (RSV). Global incidence data of COVID-19 was obtained from January 1st to June 30th 2020. Subsequently, the data were analyzed and illustrated in forms of a global temporal RSV trend diagram, a geographical RSV distribution chart, scatter graphs comparing regional RSV with average daily cases; and heat-maps comparing temporal trend of RSV with average daily cases. RESULTS Global temporal trend revealed multiple surges in RSV, which were temporally associated with certain COVID news events. Geographical distribution showed differences of query interests among regions. Although scatter graphs failed to illustrate strong correlations between regional RSV and average daily cases, the heat-maps were able to demonstrate patterns of early RSV peaks in countries with lower average daily cases, for queries “Mask”, “Hand Sanitizer”, and “Disinfectant”, upon incorporating with the temporal element into analysis. CONCLUSIONS Early public awareness of multiple preventive measures was observed in countries with lower daily average cases. Public health authorities may look into early public awareness as an effective measure for future disease control.