Decreased eosinophil counts and elevated lactate dehydrogenase predict severe COVID-19 patients with underlying chronic airway diseases

Abstract

Background: Several predictors for the severity of coronavirus disease 2019 (COVID-19) have been reported, including decreased circulating lymphocytes and eosinophil counts. However, chronic airway in ammation characterized by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19. We aimed to investigate the predictors for the severity of COVID-19 in patients with chronic airway diseases. Methods: In this retrospective cohort study, we reviewed medical records of all laboratory-con rmed COVID-19 patients with chronic bronchitis, chronic obstructive pulmonary disease (COPD) and asthma admitted in Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from January 26 th to April 3 rd. The Tongji Hospital ethics committee approved this study. Results: There were 59 patients with underlying chronic airway in ammation including chronic bronchitis, COPD, and asthma. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6 vs. 1.1× 10 /L, p < 0.001), eosinopenia (< 0.02 × 10 /L, 73% vs. 24%, p < 0.001), increased lactate dehydrogenase (LDH) (471.0 vs. 230.0 U/L, p < 0.001) and elevated IL-6 level (47.4 vs. 5.7 pg/ml, p = 0.002) on admission. Eosinopenia and elevated LDH were signi cantly associated with disease severity in both univariate and multivariate regression models included the above variables. Eosinopenia was also an independent risk factor for mortality of this cohort in a multivariate model included the above variables. Moreover, eosinophil counts and LDH levels tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially eosinophil counts. Conclusions: Eosinopenia and elevated LDH are potential predictors of disease severity in COVID-19 patients with underlying chronic airway diseases. Theses predictors may help clinicians identify the severe COVID-19 patients with chronic bronchitis, COPD, and asthma.

Epidemiological and laboratory characteristics of Omicron infection in a general hospital in Guangzhou: a retrospective study

“…Moreover, research has revealed that Omicron is more prevalent in Africa and Asia, and less common in Europe and North America (16). Recently, the use of cycle threshold (Ct) values of genes associated with Omicron infection has gained attention as a potential predictor of viral load (17)(18)(19). Additionally, previous reports have indicated that Ct values for COVID-19 correlate with serum biomarkers.…”

Mepolizumab as a Potential Protective Factor of COVID-19 Mortality: A Case Report of Chronic Bronchitis and Asthma in an Elderly Patient

“…The risk of mortality in patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) increases several-fold for those with multiple comorbidities [ 1 ]. Some of these comorbidities include chronic bronchitis [ 2 ], hypertension [ 3 ], and coronary artery disease [ 4 ]. However, the risk of mortality due to SARS-CoV-2 is unclear in patients with asthma [ 5 ].…”