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

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.