Acta Scientific Microbiology (ISSN: 2581-3226)

Editorial Volume 5 Issue 1

HScore could be a Predictor of COVID-19 Outcomes

Attapon Cheepsattayakorn1,3*, Ruangrong Cheepsattayakorn2 and Porntep Siriwanarangsun3

110th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand
2Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
3Faculty of Medicine, Western University, Pathumtani Province, Thailand

*Corresponding Author: Attapon Cheepsattayakorn, 10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand.

Received: November 16, 2021 ; Published: December 01, 2021

The first commonly clinical criteria used for the diagnosis of secondary hemophagocytic lymphohistiocytosis (sHLH) was established in the HLH-2000 study [1] and in 2014, a hemophagocytic syndrome clinical scoring system (HScore) has been developed for the diagnosis of sHLH [2,3]. For monitoring hyperinflammation (HI) in COVID-19, HScore has been proposed [4]. San., et al. demonstrated in their study on the determining the COVID-19 severity by HScore, MuLBSTA, Quick SOFA (qSOFA), Sequential Organ Failaure Assessment (SOFA), and the Brescia-COVID Respiratory Severity Scale (BCRSS) that the area under the curve (AUC) of the HScore, MuLBSTA, SOFA, qSOFA, and BRCSS were 0.698, 0.860, 0.958, 0.961, and 0.977, respectively [5]. At the time of hospital admission, the calculation of the qSOFA and BRCSS can predict COVID-19 patients’ critical clinical outcomes, and the predictive values of SOFA, MuLBSTA, and HScore are inferior to those of qSOFA and BRCSS [5]. A recent study conducted by Ardern-Jones., et al. in a small cohort that % HScore demonstrated no excess mortality compared to the whole cohort, whereas, % HScore were lower in older patients (p < 0.0001) and did not predict reliably the outcomes at any cut-off value (AUROC: 0.533, p = 0.211, Odd Ratios: 0.99) [6]. Nevertheless, severe inflammation in COVID-19 may be reflected by high HScore (at least 130) rather than sHLH, and some investigators have recommended using this score in all COVID-19 patients [2,7,8]. HScore could be affected by the large randomized control trials’ data that have modified the practice of hydroxychloroquine or lopinavir/ritonavir prescription in favor of steroid use [9,10].


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  6. Ardern-Jones M., et al. “Secondary haemophagocytic lymphohistiocytosis in hospitalized COVID-19 patients as indicated by a modified HScore in infrequent and high scores do not associate with increased mortality”. Clinical Medicine5 (2021): e543-e547.
  7. Takami A. “Possible role of low dose etoposide therapy for hemophagocytic lymphohistiocytosis by COVID-19”. International Journal of Hematology 112 (2021): 122-124.
  8. Bordbar M., et al. “Assessment of the HScore as a predictor of disease outcome in patients with COVID-19”. BMC Pulmonary Medicine 21 (2021): 338.
  9. RECOVERY Collaborative Group., et al. “Dexamethasone in hospitalized patients with COVID-19-preliminary report”. The New England Journal of Medicine 384 (2020): 693-704.
  10. RECOVERY Collaborative Group., et al. “Effect of hydroxychloroquine in hospitalized patients with COVID-19”. The New England Journal of Medicine 383 (2020): 2030-2040.


Citation: Attapon Cheepsattayakorn., et al. “HScore could be a Predictor of COVID-19 Outcomes”. Acta Scientific Microbiology 5.1 (2022): 01-02.


Copyright: © 2021 Attapon Cheepsattayakorn., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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