Journal of Clinical PracticeJournal of Clinical Practice2220-30952618-8627Eco-Vector6355210.17816/clinpract63552Research ArticleMajor predictive risk factors for а cytokine storm in COVID-19 patients (a retrospective clinical trials)AnisenkovaAnna Yu.anna_anisenkova@list.ruhttps://orcid.org/0000-0001-5642-621XApalkoSvetlana V.<p>Cand. Sci. (Biol.)</p>svetlana.apalko@gmail.comhttps://orcid.org/0000-0002-3853-4185AsaulenkoZakhar P.<p>MD</p>zakhariy@list.ruhttps://orcid.org/0000-0001-7062-065XBogdanovAlexander N.<p>Dr. Sci. (Med.), Professor</p>anbmapo2008@yandex.ruhttps://orcid.org/0000-0003-1964-3690VologzhaninDmitry A.<p>Dr. Sci. (Med.)</p>volog@bk.ruhttps://orcid.org/0000-0002-1176-794XGarbuzovEvgenii Y.<p>MD</p>eugarbouzov@mail.ruhttps://orcid.org/0000-0003-2990-0320GlotovOleg S.<p>Cand. Sci. (Biol.)</p>olglotov@mail.ruhttps://orcid.org/0000-0002-0091-2224KamilovaTatyana A.<p>Cand. Sci. (Biol.)</p>kamilovaspb@mail.ruhttps://orcid.org/0000-0001-6360-132XKlitsenkoOlga A.<p>Cand. Sci. (Biol.), Associate Professor</p>olkl@yandex.ruhttps://orcid.org/0000-0002-2686-8786MininaEvdokiia M.dulsik@list.ruhttps://orcid.org/0000-0002-2606-7057MosenkoSergei V.<p>Cand, Sci (Med.)</p>neurologist@mail.ruhttps://orcid.org/0000-0002-1357-4324KhobotnikovDmitry N.<p>MD</p>Xobotnikov@bk.ruhttps://orcid.org/0000-0002-2943-9004SсherbakSergey G.<p>Dr. Sci. (Med.), Professor</p>b40@zdrav.spb.ruhttps://orcid.org/0000-0001-5047-2792Saint-Petersburg City Hospital No 40 of Kurortny DistrictSaint-Petersburg State UniversityNorth-Western State Medical University named after I.I. MechnikovMilitary Medical Academy of S.M. Kirov150320211215151703202131032021Copyright © 2021, Anisenkova A.Y., Apalko S.V., Asaulenko Z.P., Bogdanov A.N., Vologzhanin D.A., Garbuzov E.Y., Glotov O.S., Kamilova T.A., Klitsenko O.A., Minina E.M., Mosenko S.V., Khobotnikov D.N., Sсherbak S.G.2021<p><strong><em>Background: </em></strong><em>According to WHO, as of March 31, 2021, 127 877 462 confirmed cases of the new COVID-19 coronavirus infection were registered in the world, including 2 796 561 deaths (WHO Coronavirus Disease). COVID-19 is characterized by a wide range of clinical manifestations, from asymptomatic to a rapid progression to severe and extremely severe. Predictive biomarkers for the early detection of high-risk individuals have become a matter of great medical urgency. <strong>Aims:</strong> Search for the predictors of a cytokine storm in patients with COVID-19 infection and creation of a risk scale of this complication for practical applications. <strong>Methods:</strong> The study included 458 patients with confirmed COVID-19 infection with signs of viral lung lesions according to the computer tomography data. The patients were divided into 2 groups: those with a stable course of moderate severity (100 patients) and those with progressive moderate, severe and extremely severe course (358 patients). <strong>Results:</strong> It has been established that the main risk factors for the development of a cytokine storm in COVID-19 patients are the following: interleukin-6 concentration 23 pg/ ml, dynamics of the index on the NEWS scale 0, ferritin concentration 485 ng/ml, D-dimer concentration 2.1, C-reactive protein concentration 50 mg/l, number of lymphocytes in the blood 0.72</em><em>109/l, age 40 years. The cytokine storm incidence correlates with an increase in the number of risk factors. For the practical testing the scale was applied in 3 groups. In patients of the first group (01 factor) almost no cytokine storm risk was found, in the second group (2 -3 factors) the probability of the storm was 55% (increase by 35.5 times), in the third group (4 risk factors) it reached 96% (increase by 718 times). <strong>Conclusion:</strong> The diagnostic and monitoring criteria of a cytokine storm have been established in patients with COVID-19 infection. The developed prognostic scale allows identification of patients at high risk of developing a cytokine storm so that early anti-inflammatory therapy could be started.</em></p>COVID-19 infectioncytokine stormearly diagnosis and monitoringинфекция COVID-19цитокиновый штормранняя диагностика и мониторинг[Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620–2629. doi: 10.1172/JCI137244][Wiersinga WJ, Rhodes A, Cheng AC, et al. 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