COVID-19-associated secondary hemophagocytic lymphohistiocytosis (cytokine storm syndrome)


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Abstract

In most cases, COVID-19 has a favorable outcome. However, the risk of developing critical forms of the disease, including secondary hemophagocytic lymphohistiocytosis – HLH (cytokine storm syndrome), remains high. This dictates the interest in studying pathogenetic mechanisms, features of the clinical picture, laboratory and instrumental criteria for covid-19 disease. The article analyzes the causes of acute respiratory distress syndrome and multiple organ failure as manifestations of HLH. The necessity of monitoring signs of hyperinflammation (ferritin, C-reactive protein, etc., biomarkers of inflammation) and activation of thrombosis is substantiated, in order to make timely decisions about the beginning of pathogenetic therapy. However, there are limitations for routine testing of the level of Pro-inflammatory cytokines. Information about the diagnostic criteria of HLH is summarized, and the expediency of these criteria for establishing secondary HLH, which has complicated the course of COVID-19, is emphasized.

About the authors

Ekaterina I. Alekseeva

National Medical Research Center for Children’s Health; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: alekatya@yandex.ru
ORCID iD: 0000-0002-3874-4721
SPIN-code: 4713-9943

MD, PhD, Professor, Corresponding Member of the RAS

Russian Federation, 2 bld 1 Lomonosovsky prosp., 119991, Moscow; Moscow

Rustem F. Tepaev

National Medical Research Center for Children’s Health; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: tepaev@nczd.ru
ORCID iD: 0000-0001-6667-9472
SPIN-code: 3907-3234

MD, PhD

Russian Federation, Moscow; Moscow

Ilia Y. Shilkrot

National Association of Non-Governmental Medical Organizations

Email: 7606399@gmail.com
ORCID iD: 0000-0003-0369-9593
SPIN-code: 5826-6385

MD, PhD

Russian Federation, Moscow

Tatyana M. Dvoryakovskaya

National Medical Research Center for Children’s Health, Moscow; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: bzarova@nczd.ru
ORCID iD: 0000-0002-8165-6401
SPIN-code: 7524-7085

MD, PhD

Russian Federation, Moscow; Moscow

Aleksander G. Surkov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: asurkov@1msmu.ru
ORCID iD: 0000-0001-6823-0273
SPIN-code: 2805-9855

MD, PhD

Russian Federation, Moscow

Ivan A. Kriulin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: kriulin.vanya@yandex.ru
ORCID iD: 0000-0003-2370-3182

PhD Student

Russian Federation, Moscow

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