About: SARS-CoV-2 Infection Associated Hemophagocytic Lymphohistiocytosis: An autopsy series with clinical and laboratory correlation.

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About: SARS-CoV-2 Infection Associated Hemophagocytic Lymphohistiocytosis: An autopsy series with clinical and laboratory correlation. Goto Sponge NotDistinct Permalink

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Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	SARS-CoV-2 Infection Associated Hemophagocytic Lymphohistiocytosis: An autopsy series with clinical and laboratory correlation.
Creator	Zhao, Qing Burks, Eric Kritselis, Michael Kataria, Yachana Lerner, Adam Prilutskiy, Andrey Quillen, Karen Sarosiek, Shayna Shevtsov, Artem Sloan, J Vadlamudi, Charitha Yambayev, Ilyas
source	MedRxiv
abstract	Background: A subset of COVID-19 patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. Pathologic studies to date have largely focused on the pulmonary finding of diffuse alveolar damage (DAD). To this aim, we study the reticuloendothelial organs of four consecutive patients dying of COVID-19 and correlate with clinical and laboratory parameters to detect HLH. Methods: Autopsies restricted to chest and abdomen were performed on four patients who succumbed to COVID-19. Spleen, liver, and multiple pulmonary hilar/mediastinal lymph nodes were sampled in all cases. Bone marrow was obtained by rib squeeze in a subset of cases. Routine H&E staining as well as immunohistochemical staining for CD163 was performed to detect hemophagocytosis. Clinical and laboratory results from pre-mortem blood samples were used to calculate H-scores. Findings: All four cases demonstrated DAD within the lungs. Three of the four cases had histologic evidence of hemophagocytosis within pulmonary hilar/mediastinal lymph nodes. One case showed hemophagocytosis in the spleen but none showed hemophagocytosis in liver or bone marrow. Lymphophagocytosis was the predominant form of hemophagocytosis observed. One patient showed diagnostic features of HLH with an H-score of 217 while a second patient was likely HLH with a partial H-score of 145 due to missing triglyceride level. Both patients exhibited high fever and early onset rise in serum ferritin; however, neither bicytopenia, pancytopenia, nor hypofibrinogenemia were observed in either. The remaining two patients had H-scores of 131 and 96. Interpretation: This is the first report of SARS-CoV-2 associated HLH. Identification of HLH in a subset of patients with severe COVID-19 will inform clinical trials of therapeutic strategies.
has issue date	2020-05-12(xsd:dateTime)
bibo:doi	10.1101/2020.05.07.20094888
has license	medrxiv
sha1sum (hex)	4470db4e1059a0eb24a5619654ba23b9256363f1
schema:url	https://doi.org/10.1101/2020.05.07.20094888
resource representing a document's title	SARS-CoV-2 Infection Associated Hemophagocytic Lymphohistiocytosis: An autopsy series with clinical and laboratory correlation.
resource representing a document's body	covid:4470db4e1059a0eb24a5619654ba23b9256363f1#body_text
is schema:about of	named entity 'SUBSET' named entity 'COVID-19' named entity 'clinical features' named entity 'COVID' named entity 'cytokine storm' named entity 'IL-1R' named entity 'NBF' named entity 'Herpesviridae' named entity 'receptor' named entity 'H1N1' named entity 'inflammation' named entity 'HLH' named entity 'thrombocytopenia' named entity 'red pulp' named entity 'spleens' named entity 'severe acute respiratory syndrome coronavirus 2' named entity 'COVID' named entity 'correlation' named entity 'COVID' named entity 'CC-BY-NC-ND 4.0' named entity 'Hematoxylin and Eosin' named entity 'lymphocytes' named entity 'clinical features' named entity 'hypertriglyceridemia' named entity 'acute respiratory distress syndrome' named entity 'preprint' named entity 'bicytopenia' named entity 'C-reactive protein' named entity 'Hydroxychloroquine' named entity 'preprint' named entity 'proinflammatory cytokines' named entity 'hyperferritinemia' named entity 'CC-BY-NC-ND 4.0' named entity 'RNA viruses' named entity 'medRxiv' named entity 'preprint' named entity 'SARS-CoV-1' named entity 'anemia' named entity 'electronic health record' named entity 'HLH' named entity 'histologic' named entity 'epidemic' named entity 'hemophagocytosis' named entity 'preprint' named entity 'lung' named entity 'preprint' named entity 'morphologic' named entity 'CRP' named entity 'biopsies' named entity 'CC-BY-NC-ND 4.0' named entity 'SARS-CoV-2' named entity 'Kupffer cell' named entity 'intubated' named entity 'infection' named entity 'lymphocytes' named entity 'antigen presentation' named entity 'life-threatening disease' named entity 'high fever' named entity 'Ferritin' named entity 'sepsis' named entity 'HLH' named entity 'autosomal recessive mutations' named entity 'preprint' named entity 'hemophagocytosis' named entity 'small RNA' named entity 'Immunohistochemistry' named entity 'EBV' named entity 'Histologically' named entity 'HLH' named entity 'Mediastinal' named entity 'HLH' named entity 'IL-1R' named entity 'histiocytes' named entity 'sinuses'

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