A Case of Delayed COVID-19-Related Macrophage Activation Syndrome
Bibliographic record
Abstract
Although coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, clinical experiences have shown that almost no system is exempted. The severity of the disease can also range from mild presentation with complaints such as headache, aches and pains, taste and sense of smell disturbances to a more severe presentation with acute respiratory distress syndrome (ARDS) that necessitate admission to intensive care units. In such severe presentation, hypercytokinemia, typically found in cytokine storm syndrome (CSS), particularly macrophage activation syndrome (MAS) is often present. CSS can result from diverse, heterogeneous conditions of different clinical phenotypes, such as infections, hematological, rheumatological or iatrogenic conditions leading to systemic hyperinflammation. Some clinical and laboratory findings may give clues to such a highly lethal syndrome and allow early diagnosis and introduction of effective therapy. In this case we describe a COVID-19 pneumonia patient who was discharged home following improvement in his respiratory symptoms to present few days later with a fatal form of CSS, presenting with ARDS, fulminant hepatic failure and coagulopathy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".