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
Affiliations
Ilia S. Avrusin
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Natalia N. Abramova
Intensive Care Unit Department, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Konstantin E. Belozerov
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Liudmila V. Bregel
Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, Irkutsk 664049, Russia
Olesya S. Efremova
Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, Irkutsk 664049, Russia
Alla A. Vilnits
Pediatric Infectious Department, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Julia E. Konstantinova
Pediatric Research and Clinical Center for Infection Diseases, Saint Petersburg 197022, Russia
Eugenia A. Isupova
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Tatiana L. Kornishina
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Vera V. Masalova
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Olga V. Kalashnikova
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Vyacheslav G. Chasnyk
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Yuriy S. Aleksandrovich
Intensive Care Unit Department, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Dmitri O. Ivanov
Neonatology Department, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Mikhail M. Kostik
Hospital Pediatrics, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
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.
