Dynamic hyperinflammatory response assessment using HIC scores in COVID-19: application to a large series of patients receiving anakinra - Report - MDSpire
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Dynamic hyperinflammatory response assessment using HIC scores in COVID-19: application to a large series of patients receiving anakinra
Clinical Report: Evaluation of Dynamic Hyperinflammatory Responses through HIC Scores in COVID-19
Overview
This study evaluates the Hyperinflammation in COVID-19 (HIC) score as a diagnostic and monitoring tool in hospitalized patients treated with anakinra. Findings indicate that higher HIC scores correlate with in-hospital mortality and that early CRP reduction is associated with better outcomes.
Background
Hyperinflammatory responses in severe COVID-19 can lead to significant morbidity and mortality, resembling conditions like hemophagocytic lymphohistiocytosis. The ability to dynamically assess and monitor these responses is crucial for optimizing treatment strategies, particularly with agents like anakinra. The HIC score offers a potential framework for this dynamic assessment.
Data Highlights
Outcome
Survivors
Non-Survivors
Overall Mortality
12.8%
87.2%
Time to ≥50% CRP Reduction
3.1 days
4.7 days
AUC for HIC at initiation
0.75
Key Findings
Overall mortality among patients was 12.8%.
Survivors achieved ≥50% CRP reduction in an average of 3.1 days compared to 4.7 days for non-survivors.
Dynamic changes in HIC scores and inflammatory biomarkers were observed within 3-4 days of treatment.
HIC scores at the initiation of anakinra and at final assessment effectively discriminated between survivors and non-survivors.
Baseline HIC scores had limited predictive value for outcomes.
Clinical Implications
The HIC score can serve as a valuable tool for diagnosing and monitoring hyperinflammation in COVID-19 patients. Clinicians may consider initiating anakinra when HIC is ≥35 but <70 and reassessing treatment response after 3-4 days.
Conclusion
The study supports the use of the HIC score for dynamic monitoring of hyperinflammatory responses in COVID-19, potentially guiding treatment decisions with anakinra.
by Shirkhan Amikishiyev, Rabia Deniz, Mehmet Guven Gunver, Sarvan Aghamuradov, Nevzat Koca, Burak Ince, Murat Bektas, Aysenur Yilmaz, Yagmur Canturk, Gorkem Durak, Murat Kose, Mustafa Erelel, Arif Atahan Çağatay, Serap Simsek Yavuz, Sevgi Kalayoglu Besisik, Figen Esen, Ahmet Gül
Protection against spread appeared strongest within 6 months of vaccination, while exposed vaccinated contacts showed no measurable reduction in infection risk.
