Background COVID-19, a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly presents as fever, cough, dyspnea, and myalgia or fatigue. Although the majority of patients with COVID-19 have mild symptoms, some are more prone to serious outcomes, including pneumonia, acute respiratory distress syndrome (ARDS), and even death. Hemophagocytic lymphohistiocytosis (HLH) is a severe, life-threatening inflammatory syndrome associated with intense cytokine release (also known as a “cytokine storm”). Similar to COVID-19, HLH is characterized by aggressive course leading to multi-organ failure. Main text The purpose of this review article is to draw attention to the possibility of the complication of HLH in patients with the severe course of COVID-19. Indeed, some of the clinical characteristics observed in the more severe cases of COVID-19 are reminiscent of secondary HLH (which can be triggered by infections, malignancies, rheumatological diseases, or autoimmune/immunodeficiency conditions). The pathogenesis of SARS-CoV-2 infection also suggests that HLH or a similar hyperinflammatory syndrome is the cause of the severe course of the infection. Conclusion The pathogenesis and clinical symptoms of severe COVID-19 indicate that an increased inflammatory response corresponding to HLH is occurring. Therefore, patients with severe COVID-19 should be screened for hyperinflammation using standard laboratory tests to identify those for whom immunosuppressive therapy may improve outcomes.
【저자키워드】 Coronavirus disease 2019, coronavirus, hemophagocytic lymphohistiocytosis, 【초록키워드】 COVID-19, SARS-CoV-2, ARDS, therapy, Diseases, Pathogenesis, severe COVID-19, fatigue, Clinical characteristics, Pneumonia, Infection, cough, outcomes, infections, Hyperinflammatory syndrome, hyperinflammation, Fever, Dyspnea, Patient, death, disease, HLH, mild symptoms, acute respiratory distress, Inflammatory response, Inflammatory, immunosuppressive, myalgia, Laboratory test, acute respiratory syndrome, clinical symptom, syndrome, life-threatening, multi-organ failure, Severe case, malignancies, cytokine release, pathogenesis of SARS-CoV-2, rheumatological, IMPROVE, Course, identify, caused, screened, characterized, majority, triggered, conditions, “cytokine storm”, patients with COVID-19, 【제목키워드】 severe COVID-19,