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Utility of the HScore for Predicting COVID-19 Severity
William Hannah1, Anthony Shadiack2, Melissa Markofski3
1Graduate Medical Education, Memorial Health University Medical Center, Savannah, USA.
Cureus
|January 2, 2023
Summary
The HScore effectively predicts COVID-19 severity and mortality. Non-cytokine inflammatory markers like CRP and WBC also indicate disease severity in COVID-19 patients.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Hematology
Background:
- Cytokine release syndrome (CRS) is a severe, life-threatening condition linked to COVID-19 severity.
- CRS is characterized by fever and multiple organ dysfunction.
- Predicting COVID-19 outcomes is crucial for patient management.
Purpose of the Study:
- To evaluate the HScore's utility in predicting COVID-19 severity and outcomes.
- To assess non-cytokine inflammatory markers for predicting COVID-19 severity.
- To investigate the link between cytokine storm and severe COVID-19 symptoms and mortality.
Main Methods:
- Retrospective review of patients with hemophagocytic lymphohistiocytosis (HLH) and COVID-19.
- Comparison of HLH patients (2014-2019) with COVID-19 patients (2020).
- Calculation of a modified HScore using available patient record elements.
Main Results:
- Modified HScore predicted increased odds of ventilation, ICU admission, and mortality in COVID-19 patients.
- Higher modified HScore correlated with longer hospital stays.
- C-reactive protein (CRP) and white blood cell (WBC) count were consistent non-cytokine predictors of severity.
Conclusions:
- Cytokine storm, assessed by a modified HScore, plays a role in COVID-19 severity.
- Selected non-cytokine inflammatory markers are predictive of COVID-19 disease severity.
- The HScore and inflammatory markers aid in predicting COVID-19 outcomes.
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