Several reports associated the severe Coronavirus disease-2019 (sCOVID-19) with secondary-haemophagocytic lymphohistiocytosis (sHLH) and proposed the HScore table for sCOVID-19 patients. We conducted a meta-analysis to found the possible association of HScore parameters with severity in COVID-19 patients. Systematic search was performed in Medline (PubMed), EMBASE, and Cochrane databases using all HScore and COVID-19 keywords. The records were screened based on inclusion/exclusion criteria. Random/fixed-effect models were employed. The pooled mean differences were estimated for continuous parameters. The pooled odds-ratio was estimated for fever. Eighteen studies met the criteria and included in the meta-analysis (2459 patients). Significant higher levels of leukocyte, neutrophil, aspartate-transaminase (AST), ferritin, and fibrinogen, as well as lower level of lymphocyte, platelet, and hemoglobin were found in sCOVID-19 patients compared to non-severe ones. Fever was nearly associated with 2 times increased odds of sCOVID-19 (p-value = 0.051). Lymphopenia, thrombocytopenia, hypohemoglobinemia, hyperferritinemia, high levels of AST, and fever are common features of both sCOVID-19 and HLH. However, leukocytosis, neutrophilia, and hyperfibrinogenemia found in sCOVID-19 contrast with HScore. Conclusively, HScore parameters could be risk factors for the severity of COVID-19. However, some parameters’ roles are contradictory, suggesting further investigation and a new way of HScore interpretation for sCOVID-19 patients.