• Rafael Benavente, Camila Peña, Allyson Cid, Nicolás Cabello, Pablo Bustamante, Marco Álvarez, Elizabeth Henríquez, Andrés Soto, and Erika Rubilar.
• Internal Medicine Department, Universidad de Chile, Santiago, Chile.
• Rev Med Chil. 2023 Feb 1; 151 (1): 152215-22.

BackgroundPatients with Coronavirus Disease 2019 (COVID-19) frequently experience a hyperinflammatory syndrome leading to unfavorable outcomes. This condition resembles Secondary Hemophagocytic Lymphohistiocytosis (sHLH) described in neoplastic, rheumatic and other infectious diseases. A scoring system (HScore) that evaluates underlying immunosuppression, temperature, organomegaly, cytopenias, ferritin, triglycerides, fibrinogen and AST was validated for sHLH, and recently proposed to evaluate hyperinflammation in COVID-19.AimTo assess the presence of sHLH among patients with COVID-19 admitted for hospitalization and to evaluate Hscore as a prognostic tool for poor outcomes.Material And MethodsOne hundred forty-three patients aged 21-100 years (64% males) admitted because of COVID-19 were enrolled in a prospective study. HScore was calculated within 72 hours admission. The incidence of sHLH during hospitalization was evaluated. Additionally, the relationship between a HScore ≥ 130 points and either the requirement of mechanical ventilation or 60-days mortality was explored.ResultsThe median HScore was 96 (33-169). A SHLH was diagnosed in one patient (incidence 0.7%), whose HScore was 169. After adjusting for age, sex, comorbidities and obesity, HScore ≥ 130 was independently associated with the composite clinical outcome (Hazard rartio 2.13, p = 0.022).ConclusionssHLH is not frequent among COVID-19 patients. HScore can be useful to predict the risk for poor outcomes.

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