Predictive_criteria_for_COVID-19_cytokine_storm v.0
12 laboratory parameters included in three coherent clusters predict development of cytokine storm (CS). The first cluster included decreased levels of albumin and percentage of lymphocytes, along with increased absolute numbers of neutrophils in patients in storm compared with patients who did not develop a storm. The second cluster included the increased levels of alanine aminotransaminase (ALT), aspartate aminotransferase (AST), D-dimers, LDH and troponin I. The third cluster included the decreased anion gap and increased levels of chloride, potassium and blood urea nitrogen (BUN):creatinine ratio. The results highlight an important component of tissue damage occurring during the COVID-CS. The predictive requirement for the first cluster consisted of an albumin < 2.87mg/mL OR lymphocytes < 10.2%, OR neutrophil absolute number > 11.4 10^3/mL. For the second cluster, ALT > 60IU/L, OR AST > 87IU/L, OR D-dimers > 4930ng/mL, OR LDH > 416U/L OR troponin I > 1.09ng/mL were required. For the third cluster, anion gap < 6.8mmol/L, OR chloride > 106mmol/L, OR potassium > 4.9mmol/L OR BUN: creatinine ratio > 29 were required.
To develop predictive criteria for COVID-19-associated cytokine storm (CS), a severe hyperimmune response that results in organ damage in some patients infected with COVID-19. That criteria are hypothesized for inflammation and cell death would predict this type of CS.
The criteria can be readily used in clinical practice to determine the need for an early therapeutic regimen, block the hyperimmune response and possibly decrease mortality. Criteria are met when patients fulfil all the entry criteria which are: +Signs/symptoms of COVID-19, reverse transcriptase PCR(RT-PCR) positive for COVID-19 and +ground-glass opacity(GGO) by high-resolution CT(HRCT) (or chest X-ray) and at least one criterion per each cluster. Cut-off values were calculated using a genetic algorithm.
-Caricchio R, et al. Ann Rheum Dis 2020;0:1–8. doi:10.1136/annrheumdis-2020-218323 -Ann Rheum Dis: first published as 10.1136/annrheumdis-2020-218323 on 25 September 2020. Downloaded from http://ard.bmj.com/ on November 22, 2020.
OBSERVATION.predictive_criteria_for_covid_19_cytokine_storm.v0, EVALUATION.predictive_criteria_for_covid_19_cytokine_storm.v0
