Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that is responsible for coronavirus disease 2019 (COVID-19), which has rapidly spread across the world, becoming a pandemic. The “cytokine storm” (CS) in COVID-19 leads to the worst stage of illness, and its timely control through immunomodulators, corticosteroids, and cytokine antagonists may be the key to reducing mortality. After reviewing published studies, we proposed a Cytokine Storm Score (CSs) to identify patients who were in this hyperinflammation state, and at risk of progression and poorer outcomes. We retrospectively analyzed 31 patients admitted to Infectious Disease Department in “St. Maria” Hospital in Terni with confirmed SARS-CoV-2 infections, and analyzed the “CS score” (CSs) and the severity of COVID-19. Then we conducted a prospective study of COVID-19 patients admitted after the definition of the CSscore. This is the first study that proposes and applies a new score to quickly identify COVID-19 patients who are in a hyperinflammation stage, to rapidly treat them in order to reduce the risk of intubation. CSs can accurately identify COVID-19 patients in the early stages of a CS, to conduct timely, safe, and effect administration of immunomodulators, corticosteroids, and cytokine antagonists, to prevent progression and reduce mortality.

Highlights

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged for the first time in Wuhan, China, in December 2019

  • The aim of our study is to report a new smart score that can identify at-risk patients so they may be quickly treated and the progression of COVID-19 may be prevented

  • We planned a retrospective analysis of data on COVID-19 patients admitted to the Infectious Disease Department of Terni Hospital, Italy, from March 11 to April 15, 2020

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Summary

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged for the first time in Wuhan, China, in December 2019. The virus is responsible for coronavirus disease 2019 (COVID-19), which has rapidly spread across the world. The World Health Organization (WHO) declared COVID-19 a pandemic in March 2020 [1]. As of August 21, 2020, the WHO reported 22.536.278 confirmed cases of coronavirus disease 2019 (COVID-19) worldwide. [2] As of August 21, there have been 256,118 confirmed cases with 35,418 deaths for COVID-19 in Italy [3]. Patients with coronavirus disease 2019 (COVID-19) exhibited a broad spectrum of clinical symptoms. The disease often begins with flu-like symptoms, such as fever, fatigue, dry cough, shortness of breath, headaches, chest tightness, chest pain, and muscle pain. Some patients present with nausea, vomiting, and diarrhea [4]

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