key: cord-0700145-ekzk7ojv authors: Oguz, F.; Paseau, T.; Reper, P. title: A score combining early detection of cytokines accurately predicts COVID-19 severity and intensive care unit transfer: if early cytokines scoring results available, to compare with existing severity scores and CT scan observations date: 2021-01-30 journal: Int J Infect Dis DOI: 10.1016/j.ijid.2021.01.059 sha: 39e273956393a1e0a1929e3022a828d39cccf7d8 doc_id: 700145 cord_uid: ekzk7ojv nan Keywords: Covid diagnosis, cytokines, critical, score To the Editor The interest of combining cytokines detection at the early phase of Covid 19 infection has been recently reported by Nagant and coll to predict the severity of the disease and the probability of intensive care transfer (1). If cytokines are easily evaluable in serum and have been proposed as potential immunological biomarkers for predicting disease progression (2, 3) it remains dependant on the delay after hospital admission to obtain these serum determinations. This is a critical factor for a score combining only cytokines detection to predict illness evolution. It is important to know in these observations how much time after admission cytokines results were obtained to calculate the prediction score in Covid 19 patients. This important information has not been reported in this interesting work. The cytokine score results could be correlated with more easily and quickly obtainable patients evaulations, as the results of clinical examination (respiratory rate) or blood gas evaluation with cutaneous Oxygen saturation follow-up, oxygen supplementation or arterial blood gas examinations with PaO2 and PaO2/FiO2 ratio determination. Different existing scores using this easily available data like Quick COVID-19 Severity Index (qCSI) or the ROX score combining these clinical features and oxygenation supplementation or evaluation have been developed to assess the probability of respiratory distress which remains one of the major causes of intensive care admission for Covid 19 patients and to identify in this population patients at risk of severe respiratory complications 4,5). As reported by Nagant and coll the WHO classification effectively referred to these wellknown and easily available data collected in emergency rooms to classify Covid 19 patients. It would also be interesting to compare the results of the calculated cytokine scoring with chest CT scan results and particularly with the extension of lung area showing typical pulmonary infiltrates suggesting Covid 19 lesions which also inform about the severity of the Covid 19 lung lesiosn (6, 7) . So this cytokine score calculation could effectively contribute to confirm the severity of the Covid 19 illness but this score needs to be quickly obtained after emergency admission. Otherwise other well described scores or easy to perform examinations give rapidly significant indications about the severity of the Covid 19 illness and the probability of intensive care admission in most cases for respiratory support. Financial support: None. Conflict of interest statement: The authors declare they have no conflict of interest. Ethical Approval: None All mentioned authors contributed to this article submission. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. A score combining early detection of cytokines accurately predicts COVID-19 severity and intensive care unit transfer Longitudinal analyses reveal immunological misfiring in severe COVID-19 Clinical value of immuneinflammatory parameters to assess the severity of coronavirus disease 2019 Development and Validation of the Quick COVID-19 Severity Index: A Prognostic Tool for Early Clinical Decompensation An Index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia Management of COVID-19 Respiratory Distress