Assessment of Admission COVID-19 Associated Hyperinflammation Syndrome Score in Critically-Ill COVID-19 Patients


YILDIRIM M., HALAÇLI B., YÜCE D., GÜNEGÜL Y., Ersoy E. O. , TOPELİ İSKİT A.

JOURNAL OF INTENSIVE CARE MEDICINE, vol.38, no.1, pp.70-77, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 38 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1177/08850666221131265
  • Journal Name: JOURNAL OF INTENSIVE CARE MEDICINE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.70-77
  • Keywords: COVID-19, SARS-CoV-2, hyperinflammation, score, cHIS, intensive care unit, SEPSIS
  • Hacettepe University Affiliated: Yes

Abstract

Purpose We aimed to evaluate the relation between admission COVID-19 associated hyperinflammatory syndrome (cHIS) score and intensive care unit (ICU) outcomes. Materials and Methods Patients with laboratory confirmed COVID-19 admitted to our ICU between 20(th) March 2020-15(th) June 2021 were included. Patients who received immunomodulatory treatment except corticosteroids were excluded. Main outcomes were ICU mortality and invasive mechanical ventilation (IMV) requirement after ICU admission. Results Three hundred and seventy patients with a median (IQR) age of 66 (56-77) were analyzed. Median admission cHIS score was 3 (2-4). A cHIS score >= 3 was found to be associated with ICU mortality (sensitivity = 0.63, specificity = 0.50; p < 0.01) and IMV requirement after ICU admission (sensitivity = 0.61, specificity = 0.51; p < 0.01). Patients with an admission cHIS score >= 3 (n = 199) had worse median admission APACHEII, SOFA scores and PaO2/FiO(2) ratio than others (n = 171) (p < 0.01). IMV requirement after ICU admission (38.5% vs 26.1%;p = 0.03), ICU (36.2% vs 25.1%;p = 0.02), hospital (39.1% vs 26.9%;p = 0.01) and 28th day (28.1% vs 19.1%;p = 0.04) mortality were higher in patients with admission cHIS score >= 3 than others (p < 0.01). Age <65 years, malignancy and higher admission SOFA score were independent variables associated with admission cHIS score >= 3. Conclusion Critically-ill COVID-19 patients with admission cHIS score >= 3 have worse disease severity and outcomes than other patients.