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Volume 10
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10.3390/jcm10020297
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Article

When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It

by
Stefano Cappanera
1,*,
Michele Palumbo
1,
Sherman H. Kwan
2,
Giulia Priante
1,
Lucia Assunta Martella
1,
Lavinia Maria Saraca
1,
Francesco Sicari
1,
Carlo Vernelli
1,
Cinzia Di Giuli
1,
Paolo Andreani
3,
Alessandro Mariottini
3,
Marsilio Francucci
4,
Emanuela Sensi
5,
Monya Costantini
6,
Paolo Bruzzone
7,
Vito D’Andrea
8,
Sara Gioia
9,
Roberto Cirocchi
10 and
Beatrice Tiri
1
1
Clinical Infectious Disease, Department of medicine, St. Maria Hospital, 05100 Terni, Italy
2
Department of General Surgery, Royal Perth Hospital, Perth 6000, Australia
3
Hematology and Microbiology Laboratory, St. Maria Hospital, 05100 Terni, Italy
4
Department of General and Oncologic Surgery, St. Maria Hospital, 05100 Terni, Italy
5
Department of Critical Care Medicine and Anesthesiology, St. Maria Hospital, 05100 Terni, Italy
6
Pharmacy Unit, St. Maria Hospital, 05100 Terni, Italy
7
Department of General and Specialist Surgery “Paride Stefanini”, 00185 Rome, Italy
8
Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy
9
Legal Medicine, University of Perugia, 06123 Perugia, Italy
10
Department of General and Oncologic Surgery, University of Perugia, St. Maria Hospital, 05100 Terni, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(2), 297; https://doi.org/10.3390/jcm10020297
Received: 12 December 2020 / Revised: 29 December 2020 / Accepted: 13 January 2021 / Published: 15 January 2021
(This article belongs to the Section Infectious Diseases)
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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. View Full-Text
Keywords: COVID-19; cytokine storm; ARDS COVID-19; cytokine storm; ARDS
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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MDPI and ACS Style

Cappanera, S.; Palumbo, M.; Kwan, S.H.; Priante, G.; Martella, L.A.; Saraca, L.M.; Sicari, F.; Vernelli, C.; Di Giuli, C.; Andreani, P.; Mariottini, A.; Francucci, M.; Sensi, E.; Costantini, M.; Bruzzone, P.; D’Andrea, V.; Gioia, S.; Cirocchi, R.; Tiri, B. When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It. J. Clin. Med. 2021, 10, 297. https://doi.org/10.3390/jcm10020297

AMA Style

Cappanera S, Palumbo M, Kwan SH, Priante G, Martella LA, Saraca LM, Sicari F, Vernelli C, Di Giuli C, Andreani P, Mariottini A, Francucci M, Sensi E, Costantini M, Bruzzone P, D’Andrea V, Gioia S, Cirocchi R, Tiri B. When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It. Journal of Clinical Medicine. 2021; 10(2):297. https://doi.org/10.3390/jcm10020297

Chicago/Turabian Style

Cappanera, Stefano, Michele Palumbo, Sherman H. Kwan, Giulia Priante, Lucia A. Martella, Lavinia M. Saraca, Francesco Sicari, Carlo Vernelli, Cinzia Di Giuli, Paolo Andreani, Alessandro Mariottini, Marsilio Francucci, Emanuela Sensi, Monya Costantini, Paolo Bruzzone, Vito D’Andrea, Sara Gioia, Roberto Cirocchi, and Beatrice Tiri. 2021. "When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It" Journal of Clinical Medicine 10, no. 2: 297. https://doi.org/10.3390/jcm10020297

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