Secondary hemophagocytic lymphohistiocytosis versus cytokine release syndrome in severe COVID-19 patients.
Exp Biol Med (Maywood)
; 246(1): 5-9, 2021 01.
Article
in English
| MEDLINE | ID: covidwho-796862
ABSTRACT
IMPACT STATEMENT Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS). Although a recent report indicated favorable responses to the interleukin-1 receptor antagonist, anakinra in eight patients with COVID-19 secondary HLH diagnosed using the HScore calculation, others have suggested that the diagnosis of secondary HLH is uncommon and that the use of the HScore has limited value in guiding immunomodulatory therapy for COVID-19. Here, we provide additional perspective on this important controversy based upon comparisons between 14 COVID-19 cytokine storm patients and 10 secondary HLH patients seen immediately prior to the pandemic. We hypothesize that identification of HLH may relate to the severity or timing of cytokine release and suggest distinguishing between cytokine release syndrome and secondary HLH, reserving the latter term for cases fulfilling diagnostic criteria.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lymphohistiocytosis, Hemophagocytic
/
Cytokine Release Syndrome
/
COVID-19
Type of study:
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Exp Biol Med (Maywood)
Journal subject:
Biology
/
Physiology
/
Medicine
Year:
2021
Document Type:
Article
Affiliation country:
1535370220962043
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