ReviewClinical rheumatology2021
Haemophagocytic syndrome and COVID-19.
Review in Clinical rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- New onset of severe and long-term hepatobiliary diseases post-COVID-19 infection: a systematic review.BMC infectious diseases · 2026Pooled it
- Autoantibodies as potential prognostic factors for clinical outcomes related to COVID-19: a systematic review of inception prospective cohort studies with GRADE recommendations.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2025Pooled it
- An analysis of reported cases of hemophagocytic lymphohistiocytosis (HLH) after COVID-19 vaccination.Human vaccines & immunotherapeutics · 2023Pooled it
- Human herpesvirus-6B infection leading to hemophagocytic lymphohistiocytosis in an adult: a case report.Journal of medical case reports · 2026Article
- [Clinical analysis of nine cases of hemophagocytic lymphohistiocytosis during pregnancy: characteristics, therapeutic strategies, and maternal-infant outcomes].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2025Article
- Proteomic Analyses in COVID-19-Associated Secondary Hemophagocytic Lymphohistiocytosis.Critical care explorations · 2025Observational
- COVID-19-Associated Cold Agglutinin Syndrome and Hemophagocytosis in a Patient with Monoclonal Gammopathy of Undetermined Significance.Mediterranean journal of hematology and infectious diseases · 2025Article
- Hemophagocytic Lymphohistiocytosis Secondary to Acute Human Immunodeficiency Virus and COVID-19.Journal of medical cases · 2024Article
- Identification of biomarkers for COVID-19 associated secondary hemophagocytic lymphohistiocytosis.bioRxiv : the preprint server for biology · 2024Article
- Macrophage Activation Syndrome in Viral Sepsis.Viruses · 2024Review
- Macrophage Activation Syndrome in Children: Update on Diagnosis and Treatment.Children (Basel, Switzerland) · 2024Review
- Acute Heart Failure in the Course of Macrophage Activation Syndrome Due to Newly Diagnosed Systemic Lupus Erythematosus: Case Presentation and Literature Review.Medicina (Kaunas, Lithuania) · 2024Review
- Hemophagocytic lymphohistiocytosis during treatment of intracranial multifocal germinoma: a case report and literature review.Frontiers in oncology · 2024Article
- Etoposide Therapy of Cytokine Storm Syndromes.Advances in experimental medicine and biology · 2024Review
- Laboratory Features and Pathology of Cytokine Storm Syndromes.Advances in experimental medicine and biology · 2024Review
- Fatal COVID-19 Infection in Two Children with STAT1 Gain-of-Function.Journal of clinical immunology · 2023Article
- A case of hemophagocytic lymphohistiocytosis in a hemodialysis patient with coronavirus disease 2019.CEN case reports · 2023Article
- Hemophagocytic Lymphohistiocytosis: A Rare Complication of COVID-19 in a Patient With Sickle Cell Anemia.Cureus · 2023Article
- COVID-19 Complications in a Newly Diagnosed HIV Patient: A Case of Multiple Herpesvirus Reactivation and HLH Post-ART Initiation.The American journal of case reports · 2023Article
- Viral infections in critical care: a narrative review.Anaesthesia · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Primary and secondary haemophagocytic lymphohistiocytosis (HLH) are hyperferritinaemic hyperinflammatory syndromes with a common terminal pathway triggered by different etiopathogenetic factors. HLH is characterised by a decreased capacity of interferon gamma production with an activated NK phenotype profile similar to other hyperinflammatory syndromes. Viruses are closely linked to the development of HLH as infectious triggers, and the break of tolerance to self-antigens is considered a critical mechanism involved in the development of immune-mediated conditions triggered by viral infections. Emerging studies in patients with COVID-19 are suggesting a key role of monocytes/macrophages in the pathogenesis of this viral infection, and there is a significant overlap between several features reported in severe COVID-19 and the features included in the HLH-2004 diagnostic criteria. Therefore, SARS-Cov-2, as other respiratory viruses, may also be considered a potential etiological trigger of HLH. The frequency of HLH in adult patients with severe COVID-19 is lower than 5%, although this figure could be underestimated considering that most reported cases lacked information about some specific criteria (mainly the histopathological criteria and the measurement of NK cell function and sCD25 levels). Because HLH is a multi-organ syndrome, the diagnostic approach in a patient with severe COVID-19 in whom HLH is suspected must be carried out in a syndromic and holistic way, and not in the light of isolated clinical or laboratory features. In COVID-19 patients presenting with persistent high fever, progressive pancytopenia, and hepatosplenic involvement, together with the characteristic triad of laboratory abnormalities (hyperferritinaemia, hypertriglyceridaemia, and hypofibrinogenaemia), the suspicion of HLH is high, and the diagnostic workup must be completed with specific immunological and histopathological studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.