The clinical manifestation of moderate to severe COVID-19 has parallels to secondary haemophagocytic lymphohistiocytosis (HLH) both clinically and based on molecular inflammatory response. We found no evidence to support the utility of risk stratifying COVID-19 patients using risk scoring methodology designed for HLH.

IntroductionAeromedical Evacuation (AE) is a vital role of the Defence Medical Services (DMS). With a far-reaching defence global footprint, an AE capability is crucial to enable movement of patients in the fastest, safest and least stressful way that meets or exceeds the level of care an injured or ill person may expect to receive in the UK. Operation (Op) TRENTON is a UK military humanitarian operation in support of the United Nations (UN) Mission in South Sudan.MethodsA retrospective analysis was carried out of all patients who underwent AE from the UK level 2 hospital at Bentiu during Op TRENTON over a 17-month period from June 2017 to October 2018.Results14 patients underwent AE. The median age was 36 (22–64) years and all patients were male. 21% of AEs were for UK personnel and 79% were for UN personnel. 29% of AEs were due to non-battle injury with the remainder due to disease. Musculoskeletal was the largest diagnostic group (n=4) followed by respiratory (n=3), cardiovascular (n=2), undifferentiated febrile illness (n=2), neurology (n=1), renal medicine (n=1) and psychiatry (n=1).ConclusionsPatients requiring AE from the level 2 hospital at Bentiu mostly had musculoskeletal and medical pathology, a stark contrast to the trauma patient cohort from operations in the past. The majority of patients had definitive care under the medical team highlighting the requirement for DMS physicians and the AE team, to be trained in acute, general and aviation medicine. The majority of AE moves were for UN personnel and on UN airframes, highlighting the importance of a sound understanding of the nations we are working with.