OP0313 PRELIMINARY CRITERIA FOR MACROPHAGE ACTIVATION SYNDROME ASSOCIATED WITH CORONAVIRUS DISEASE-19

Background: COVID-19 runs a severe disease associated with acute respiratory distress syndrome in subset of patients, and hyperinflammatory response developing the second week contributes to worse outcome. Inflammatory features are mostly compatible macrophage activation (MAS) observed other viral infections despite resulting milder changes. Early detection treatment MAS may be better However, available criteria for causes have not been helpful. Objectives: To identify distinct using large database enabling assess dynamic Methods: PCR-confirmed hospitalized patients followed between March September 2020 constituted discovery set. Patients considered findings by experienced physicians given anakinra or tocilizumab were classified as group remaining non-MAS group. The was then re-grouped cases exact-MAS borderline-MAS study Clinical laboratory data including Ct values PCR test obtained from database, changes evaluated especially first 14 days hospitalization. set 162 September-December used replication preliminary criteria. In set, hospitalization rules changed, all required oxygen support received dexamethasone 6mg/day equivalent glucocorticoids. Daily calculated items MAS, borderline, groups see differentiating groups, ROC curves lower upper limits (10-90%) selected parameters determine cutoff values. Results: A total 769 analysed, 77 them 83 borderline patients. There no statistically significant difference baseline loads compared according differed around 6 th day hospitalization, more than twofold increase ferritin 1.5-fold D-dimer levels help define Twelve Table 1 below. score 45 provided 79.6% sensitivity (including cases) 81.3% specificity 5 60 increased 94.9% decrease 40.8%. same similar (80.3%) replication, but (47.4-66% on 9) due control possibly masked 1. Preliminary Criteria Macrophage Activation Syndrome Associated Coronavirus Disease-19 1.Fever (>37.0 °C) 2.Ferritin concentration > 550 ng/mL 3.More 2 times within 7 onset 4.Neutrophil count 6000 cell/mm 3 5.Lymphopenia < 1000 6.Neutrophil/lymphocyte ratio 7.D-dimer ng/ml 8.More 50% 9.CRP concetration 50 mg/L 10.LDH 300 U/L 11.ALT AST 12.Procalcitonin 1.2 point each positive item assessed Days 5-7 Score calculation: Total points / 12 x 100 Possible ≥45 Definite ≥60 Conclusion: This defined most relevant would helpful possible reasonable start necessary treatments early possible. Disclosure Interests: None declared.