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

• Published in: Biomedicines Vol. 12; no. 2; p. 294
• Main Authors: Avrusin, Ilia S, Abramova, Natalia N, Belozerov, Konstantin E, Bregel, Liudmila V, Efremova, Olesya S, Vilnits, Alla A, Konstantinova, Julia E, Isupova, Eugenia A, Kornishina, Tatiana L, Masalova, Vera V, Kalashnikova, Olga V, Chasnyk, Vyacheslav G, Aleksandrovich, Yuriy S, Ivanov, Dmitri O, Kostik, Mikhail M
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.01.2024
• Subjects: Acetylsalicylic acid; Aneurysms; Aspirin; Blood; C-reactive protein; children; COVID-19; Enzymes; Erythema; Erythrocyte sedimentation rate; Heart; Hemophagocytic syndrome; hemophagocytosis; Hypotension; ICU; Immunoglobulins; Inflammation; Kawasaki disease; Lymphadenopathy; Medical examination; Medical research; Medicine, Experimental; MIS-C; Pericarditis; Splenomegaly; Thrombocytopenia; Russia; COVID-19; hemophagocytosis; MIS-C; ICU; children
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines12020294

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 ( = 79) and HScore > 91 ( = 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.