Major predictive risk factors for cytokine storm in COVID-19 patients (Clinical trials)

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Abstract

AIM: Searching for predictors of cytokine storm in patients with COVID-19 and creating a risk scale for this complication for practical implementation.

MATERIALS AND METHODS: The study included 458 patients with confirmed COVID-19 with signs of viral lung lesion according to computer tomography. The patients were divided into 2 groups: with a stable course of moderate severity (100 patients) and with progressive moderate, severe and extremely severe course (358 patients).

RESULTS: It has been established that the main risk factors for the development of cytokine storm in COVID-19 patients are interleukin-6 concentration >23 pg/ml, the dynamics of the index according to the NEWS scale ≥0, ferritin concentration >485 ng/ml, D-dimers >2,1, C-reactive protein >50 mg/l, the number of lymphocytes in the blood <0,72 ∙ 109/l, age ≥40 years. Cytokine storm incidence correlates with an increase in the number of risk factors. For practical use the scale is applied in 3 groups. In the patients of the first group (0-1 factor) almost no cytokine storm risk was detected, in the second group (2-3 factors) the probability of a storm was 55 % (increased by 35.5 times), in the third group (≥4 risk factors) reaches 96 % (increased by 718 times).

CONCLUSIONS: Diagnostic and monitoring criteria of cytokine storm in the patients with COVID-19 were established. The developed prognostic scale allows to identify patients at high risk of developing cytokine storm for early anti-inflammatory therapy.

About the authors

Anna Yu. Anisenkova

Saint Petersburg City Hospital No. 40 of Kurortny District; Saint Petersburg State University

Email: anna_anisenkova@list.ru

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, 9B Borisov str., Sestroretsk, 197706; Saint Petersburg

Svetlana V. Apalko

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: Svetlana.apalko@gmail.com
ORCID iD: 0000-0002-3853-4185
SPIN-code: 7053-2507

MD, Cand. Sci. (Biol.)

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Zakhar P. Asaulenko

Saint Petersburg City Hospital No. 40 of Kurortny District; North-Western State Medical University named after I.I. Mechnikov

Email: zakhariy@list.ru

MD

Russian Federation, 9B Borisov str., Sestroretsk, 197706; Saint Petersburg

Aleksandr N. Bogdanov

Saint Petersburg City Hospital No. 40 of Kurortny District; Saint Petersburg State University; Military Medical Academy named after S.M. Kirov

Email: anbmapo2008@yandex.ru
ORCID iD: 0000-0003-1964-3690
Scopus Author ID: 7201674748
ResearcherId: M-5163-2015

MD, Dr. Sci. (Med.), Professor

Russian Federation, 9B Borisov str., Sestroretsk, 197706; Saint Petersburg; Saint Petersburg

Dmitriy A. Vologzhanin

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: volog@bk.ru

MD, Dr. Sci. (Med.)

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Evgenii Yu. Garbuzov

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: eugarbouzov@mail.ru

MD

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Aleksandr S. Golota

Saint Petersburg City Hospital No. 40 of Kurortny District

Author for correspondence.
Email: golotaa@yahoo.com

MD, Cand. Sci. (Med.)

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Tatyana A. Kamilova

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: kamilovaspb@mail.ru

MD, Cand. Sci. (Biol.)

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Olga A. Klitsenko

North-Western State Medical University named after I.I. Mechnikov

Email: olkl@yandex.ru

MD, Cand. Sci. (Biol.), Assistant Professor

Russian Federation, Saint Petersburg

Evdokiya M. Minina

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: dulsik@list.ru

MD

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Sergey V. Mosenko

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: neurologist@mail.ru

MD, Cand. Sci. (Med.)

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Stanislav P. Urazov

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: urasta@list.ru

MD

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Dmitriy N. Khobotnikov

Saint Petersburg City Hospital No. 40 of Kurortny District

Email: Xobotnikov@bk.ru

MD

Russian Federation, 9B Borisov str., Sestroretsk, 197706

Sergey G. Sherbak

Saint Petersburg City Hospital No. 40 of Kurortny District; Saint Petersburg State University

Email: sgsherbak@mail.ru

MD, Dr. Sci. (Med.)

Russian Federation, 9B Borisov str., Sestroretsk, 197706; Saint Petersburg

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Supplementary files

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2. Fig. 1. Increased risk of developing a cytokine storm with unfavorable indicator values

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3. Fig. 2. The incidence of cytokine storms with different number of risk factors

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Copyright (c) 2021 Anisenkova A.Y., Apalko S.V., Asaulenko Z.P., Bogdanov A.N., Vologzhanin D.A., Garbuzov E.Y., Golota A.S., Kamilova T.A., Klitsenko O.A., Minina E.M., Mosenko S.V., Urazov S.P., Khobotnikov D.N., Sherbak S.G.

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