Table 2B.
Tabulated comparison of studies on COVID-19-associated HLH.
| Cases Study | Year | No of cases | COVID status at diagnosis of HLH |
HLH diagnostic tool used |
H score | HLH 2004 criteria | Elevated sCD25 | Reduced NK Cell activity | Bone marrow hemophagocytosis | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Post COVID-19 cases | |||||||||||
| Naous et al. (8) | March 2021 | 1 | Negative | HLH 2004 | 4 | N/A | N/A | + | Dexamethasone+ Etoposide | Succumbed | |
| Kalita P et al. (9) | August 2021 | 2 | Negative | H-score | 213/239 | - | N/A | N/A | + | Dexamethasone | • Discharged • Not defined |
| Wiseman et al. (10) | September 2021 | 1 | Negative | H score | 197 | 3 | N/A | N/A | + | Dexamethasone+ Etoposide | Initially improved then developed bronchopleural fistula and was on ECMO |
| Current study | 2021 | 1 | Negative | H score and HLH 2004 | 256 | 8 | + | + | Hypoplastic marrow | Dexamethasone | Succumbed |
| Ongoing COVID-19 | |||||||||||
| HLH-Diagnosed Antemortem | |||||||||||
| Verma et al. (11) | May 2021 | 1 | Positive | HLH 2004 | - | 5 | N/A | N/A | + | Dexamethasone | Succumbed |
| Schnaubelt et al. (12) | February 2021 | 3 | Positive | H-score | 239/197/256 | - | N/A | N/A | N/A | • Methylprednisolone+IVIG • Methylprednisolone • Methylprednisolone+IVIG+ Anakinra |
• Succumbed • Succumbed • Recovered |
| Thüsen et al. (13) | October 2020 | 1 | Positive | H score; autopsy | 180 | - | + | N/A | + | N/A | Succumbed |
| Tholin et al. (14) | October 2020 | 1 | Positive | HLH 2004 | - | 5 | + | N/A | + | Tocilizumab IVIG | Recovered |
| Lima et al. (15) | July 2021 | 1 | Positive | Bone marrow | 3 | N/A | N/A | + | IVIG | Succumbed | |
| HLH-diagnosed Postmortem | |||||||||||
| Retamozo et al. (16) | January 2021 | 60 retrospective cases |
Variable | H score and HLH 2004 | >169 (n = 7;11.6%) | 5 (n = 8;13.3%) | N/A | N/A | 83.3% (n = 15/18) + | Variable | 46.6% expiry |
| Pérez et al. (1) | July 2020 | 3 | Positive | HLH 2004 | - | 5 | + | N/A | + | N/A | N/A |
| Torrón et al. (17) | February 2021 | 16 | Positive | H score | >169 (n = 10) | - | N/A | N/A | + (16/16) | Steroids (14) Tocilizumab (13) | Succumbed |
| Meng et al. (18) | April 2021 | 41 retrospective cases |
Positive | H-score | >169 suspected HLH |
- | N/A | N/A | N/A | Variable | 100% died |
| Prilutskiy et al. (19) | 2020 | 4 | Positive | H score | 1 had 217 | - | N/A | N/A | BM-; Pulmonary lymph node+ | Sarilumab, Anakinra | Succumbed |
BM, Bone Marrow; ECMO, extra-corporeal membranous oxygenation; IVIG, Intravenous Immunoglobulin; MPS, Methylprednisolone; N/A, Not Available.