key: cord-0776277-w7ne9mj5
authors: Leverenz, David L; Tarrant, Teresa K
title: Is the HScore useful in COVID-19?
date: 2020-05-05
journal: Lancet
DOI: 10.1016/s0140-6736(20)31057-6
sha: 61b5529ffcdf8173802b011cffb63bc4fc409ff7
doc_id: 776277
cord_uid: w7ne9mj5

nan

In a review of 191 patients with COVID-19 admitted to hospital, 3 the IQR of ferritin concentrations at time of admission in non-survivors was 728·9-2000·0 ng/mL, and the median ferritin did not exceed 2000·0 ng/mL until 16 days after symptom onset, when most patients had experienced acute respiratory distress syndrome requiring intubation. Other HScore criteria such as hypertriglyceridaemia, splenomegaly, hepatomegaly, and bone marrow haemophagocytosis are not reported in most cohort studies of COVID-19. Finally, high fevers are weighted heavily in the HScore; however, temperature above 39·0°C does not distinguish between patients with moderate versus severe COVID-19. 4 In summary, although we agree that the detection and management of hyperinflammatory states in COVID-19 is important, we recommend against using the HScore due to a potential lack of sensitivity.

We declare no competing interests. 

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