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An elevated HScore is associated with poor clinical outcomes in COVID-19

Rafael Benavente1, Camila Peña2, Allyson Cid3

  • 1Internal Medicine Department, Universidad de Chile, Santiago, Chile.

Revista Medica De Chile
|October 31, 2023
PubMed

Insights

Secondary Hemophagocytic Lymphohistiocytosis (sHLH) is uncommon in COVID-19 patients. However, the HScore can predict poor outcomes, such as mechanical ventilation or mortality, in hospitalized COVID-19 patients.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus Disease 2019 (COVID-19) can cause hyperinflammation, mimicking Secondary Hemophagocytic Lymphohistiocytosis (sHLH).
  • The HScore, a validated tool for sHLH, has been proposed to assess COVID-19-associated hyperinflammation.

Purpose of the Study:

  • To determine the incidence of sHLH in hospitalized COVID-19 patients.
  • To evaluate the HScore's utility as a prognostic indicator for adverse outcomes in this population.

Main Methods:

  • A prospective study enrolled 143 hospitalized COVID-19 patients (aged 21-100 years).
  • The HScore was calculated within 72 hours of admission.
  • The study assessed sHLH incidence and the association between an HScore ≥ 130 and outcomes like mechanical ventilation or 60-day mortality.

Main Results:

  • The median HScore was 96 (range: 33-169).
  • The incidence of sHLH was low (0.7%), with one patient diagnosed (HScore 169).
  • An HScore ≥ 130 was independently linked to a composite poor outcome (Hazard Ratio 2.13, p=0.022), even after adjusting for confounders.

Conclusions:

  • Secondary Hemophagocytic Lymphohistiocytosis (sHLH) is infrequent in COVID-19 patients.
  • The HScore serves as a valuable tool for predicting poor clinical outcomes in hospitalized COVID-19 patients.
Abstract

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