Biomedicines (Jan 2024)

Using HScore for Evaluation of Hemophagocytosis in Multisystem Inflammatory Syndrome Associated with COVID-19 in Children

  • Ilia S. Avrusin,
  • Natalia N. Abramova,
  • Konstantin E. Belozerov,
  • Liudmila V. Bregel,
  • Olesya S. Efremova,
  • Alla A. Vilnits,
  • Julia E. Konstantinova,
  • Eugenia A. Isupova,
  • Tatiana L. Kornishina,
  • Vera V. Masalova,
  • Olga V. Kalashnikova,
  • Vyacheslav G. Chasnyk,
  • Yuriy S. Aleksandrovich,
  • Dmitri O. Ivanov,
  • Mikhail M. Kostik

DOI
https://doi.org/10.3390/biomedicines12020294
Journal volume & issue
Vol. 12, no. 2
p. 294

Abstract

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Hemophagocytic syndrome is a key point in the pathogenesis of severe forms of multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C). The factors associated with hemophagocytosis in patients with MIS-C were assessed in the present study of 94 boys and 64 girls ranging in age from 4 months to 17 years, each of whose HScore was calculated. In accordance with a previous analysis, patients with HScore ≤ 91 (n = 79) and HScore > 91 (n = 79) were compared. Patients with HScore > 91 had a higher frequency of symptoms such as cervical lymphadenopathy, dry cracked lips, bright mucous, erythema/swelling of hands and feet, peeling of fingers, edematous syndrome, hepatomegaly, splenomegaly, and hypotension/shock. They also had a higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and D-dimer levels, and a tendency to anemia, thrombocytopenia, and hypofibrinogenemia. They more often needed acetylsalicylic acid and biological treatment and were admitted to ICU in 70.9% of cases. Conclusion: The following signs of severe MIS-C were associated with HScore > 91: myocardial involvement, pericarditis, hypotension/shock, and ICU admission.

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