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. 2021 Jan 15;10(2):297.
doi: 10.3390/jcm10020297.

When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It

Stefano Cappanera  1 , Michele Palumbo  1 , Sherman H Kwan  2 , Giulia Priante  1 , Lucia Assunta Martella  1 , Lavinia Maria Saraca  1 , Francesco Sicari  1 , Carlo Vernelli  1 , Cinzia Di Giuli  1 , Paolo Andreani  3 , Alessandro Mariottini  3 , Marsilio Francucci  4 , Emanuela Sensi  5 , Monya Costantini  6 , Paolo Bruzzone  7 , Vito D'Andrea  8 , Sara Gioia  9 , Roberto Cirocchi  10 , Beatrice Tiri  1
Affiliations

When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It

Stefano Cappanera et al. J Clin Med. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that is responsible for coronavirus disease 2019 (COVID-19), which has rapidly spread across the world, becoming a pandemic. The "cytokine storm" (CS) in COVID-19 leads to the worst stage of illness, and its timely control through immunomodulators, corticosteroids, and cytokine antagonists may be the key to reducing mortality. After reviewing published studies, we proposed a Cytokine Storm Score (CSs) to identify patients who were in this hyperinflammation state, and at risk of progression and poorer outcomes. We retrospectively analyzed 31 patients admitted to Infectious Disease Department in "St. Maria" Hospital in Terni with confirmed SARS-CoV-2 infections, and analyzed the "CS score" (CSs) and the severity of COVID-19. Then we conducted a prospective study of COVID-19 patients admitted after the definition of the CSscore. This is the first study that proposes and applies a new score to quickly identify COVID-19 patients who are in a hyperinflammation stage, to rapidly treat them in order to reduce the risk of intubation. CSs can accurately identify COVID-19 patients in the early stages of a CS, to conduct timely, safe, and effect administration of immunomodulators, corticosteroids, and cytokine antagonists, to prevent progression and reduce mortality.

Keywords: ARDS; COVID-19; cytokine storm.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Cytokine Storm Score (CSs) score identifies coronavirus disease 2019 (COVID-19) patients who are doing a cytokine storm, and identifies the timing of correct administration of immunomodulators, corticosteroids, and cytokine receptor antagonists to prevent the progression of stage III COVID-19.
Figure 2
Figure 2
CS score’s algorithm.
Figure 3
Figure 3
Patients admitted to Infectious Diseases Department with confirmed SARS-CoV-2 infection between April 15 and August 31.
See this image and copyright information in PMC

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