Table 4.

Criteria proposed for hyperinflammatory syndrome associated with COVID-19 [23]

Panel: proposed cHIS criteria

Fever

Defined as a temperature of more than 38.0 °C

Macrophage activation

Defined as a ferritin concentration of 700 μg/L or more✽

Haematological dysfunction

Defined as a neutrophil to lymphocyte ratio of 10 or more, or both haemoglobin concentration of 9.2 g/dL or less and platelet count of 110 × 109 cells per L or less

Coagulopathy

Defined as a D-dimer concentration of 1.5 μg/mL or more

Hepatic injury

Defined as a lactate dehydrogenase concentration of 400 U/L or more, or an aspartate aminotransferase concentration of 100 U/L or more

Cytokinaemia

Defined as an interleukin-6 concentration of 15 pg/mL or more†, or a triglyceride concentration of 150 mg/dL or more‡, or a CRP§ concentration of 15 mg/dL or more¶

cHIS, COVID-19-associated hyperinflammatory syndrome; CRP, C-reactive protein

^✽Ferritin concentration might be elevated in end-stage renal disease on haemodialysis

^†Original validation used a 10 pg/mL threshold; post-hoc analysis suggested that 15 pg/mL has better discrimination for poor outcomes

^‡Triglycerides might be elevated due to concomitant propofol administration

^§Not high-sensitivity CRP

^¶CRP was not included in the original validation; post-hoc analysis confirmed use as a third surrogate for cytokinaemia