Eosinopenia as a prognostic factor in patients with acute exacerbation of chronic obstructive pulmonary disease

Białas, Adam J.; Kornicki, Kamil; Ciebiada, Maciej; Antczak, Adam; Dymanowska, Joanna Miłkowska; Piotrowski, Wojciech J.; Górski, Paweł

doi:10.1183/1393003.congress-2017.pa2110

Cited by 3 publications

(3 citation statements)

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“…Adam et al reported that in patients with acute exacerbations of chronic obstructive pulmonary disease, eosinopenia increases the risk of treatment failure and in-hospital mortality [8]. Other studies have also demonstrated eosinopenia in late stage bacterial pneumonias, as well as COVID-19 [9].…”

Section: Discussionmentioning

confidence: 99%

Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience

Sun

Dong

Wang

et al. 2020

Journal of Autoimmunity

205

185

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Section: Discussionmentioning

confidence: 99%

Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience

Sun

Dong

Wang

et al. 2020

Journal of Autoimmunity

205

185

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“… 44 Eosinopenia, which has now been linked with worse outcomes and poor responses to antivirals as well as to anti-IL-6 for COVID-19, 62 94–96 is a well-established signature of inflammatory respiratory pathology. 97 98 Eosinophils also play a role in the resolution of inflammation through their secretion of IL-4 and IL-14 along with a variety of lipid-based mediators of macrophage activity, 99 suggesting that a failure of type 2 immunity to resolve inflammatory monocyte and macrophage activity may also contribute to the uncontrolled inflammation in COVID-19.…”

Section: Clinical Course and Inflammatory Pathology Of Sars-cov-2 Infmentioning

confidence: 99%

IL-6 modulation for COVID-19: the right patients at the right time?

Ascierto

Wei

2021

J Immunother Cancer

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The ongoing pandemic caused by the novel coronavirus SARS-CoV-2 has disrupted the global economy and strained healthcare systems to their limits. After the virus first emerged in late 2019, the first intervention that demonstrated significant reductions in mortality for severe COVID-19 in large-scale trials was corticosteroids. Additional options that may reduce the burden on the healthcare system by reducing the number of patients requiring intensive care unit support are desperately needed, yet no therapy has conclusively established benefit in randomized studies for the management of moderate or mild cases of disease. Severe COVID-19 disease is characterized by a respiratory distress syndrome accompanied by elevated levels of several systemic cytokines, in a profile that shares several features with known inflammatory pathologies such as hemophagocytic lymphohistiocytosis and cytokine release syndrome secondary to chimeric antigen receptor (CAR) T cell therapy. Based on these observations, modulation of inflammatory cytokines, particularly interleukin (IL)-6, was proposed as a strategy to mitigate severe disease. Despite encouraging recoveries with anti-IL-6 agents, especially tocilizumab from single-arm studies, early randomized trials returned mixed results in terms of clinical benefit with these interventions. Later, larger trials such as RECOVERY and REMAP-CAP, however, are establishing anti-IL-6 in combination with steroids as a potential option for hypoxic patients with evidence of hyperinflammation. We propose that a positive feedback loop primarily mediated by macrophages and monocytes initiates the inflammatory cascade in severe COVID-19, and thus optimal benefit with anti-IL-6 therapies may require intervention during a finite window of opportunity at the outset of hyperinflammation but before fulminant disease causes irreversible tissue damage—as defined clinically by C reactive protein levels higher than 75 mg/L.

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“…Both Holland et al and Rahimi-Rad et al used cut-off value of 40 cells/mm 3 to diagnose eosinopenia. In the past, we also reported that eosinopenia would be a prognostic factor of in-hospital mortality in ECOPD 16 , however, in the present study, we used the analysis which was not applied by above mentioned authors, therefore ROC curve assessment. From one hand, AUROC analysis may still justify such statement, but from the other hand, relatively low specificity 65.2% of this marker decreased our enthusiasm significantly.…”

Section: Discussionmentioning

confidence: 99%

Eosinopenia and neutrophil-to-lymphocyte count ratio as prognostic factors in exacerbation of COPD

Karauda

Kornicki

Jarri

et al. 2021

Sci Rep

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Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPDs) are one of the most important clinical aspects of the disease, and when requiring hospital admission, they significantly contribute to mortality among COPD patients. Our aim was to assess the role of eosinopenia and neutrophil-to-lymphocyte count (NLR) as markers of in-hospital mortality and length of hospitalization (LoH) among patients with ECOPD requiring hospitalization. We included 275 patients. Eosinopenia was associated with in-hospital deaths only when coexisted with lymphocytopenia, with the specificity of 84.4% (95% CI 79.6–88.6%) and the sensitivity of 100% (95% CI 35.9–100%). Also, survivors presented longer LoH (P < 0.0001). NLR ≥ 13.2 predicted in-hospital death with the sensitivity of 100% (95% CI 35.9–100%) and specificity of 92.6% (95% CI 88.8–95.4%), however, comparison of LoH among survivors did not reach statistical significance (P = 0.05). Additionally, when we assessed the presence of coexistence of eosinopenia and lymphocytopenia first, and then apply NLR, sensitivity and specificity in prediction of in-hospital death was 100% (95% CI 35.9–100) and 93.7% (95% CI 90.1–96.3), respectively. Moreover, among survivors, the occurrence of such pattern was associated with significantly longer LoH: 11 (7–14) vs 7 (5–10) days (P = 0.01). The best profile of sensitivity and specificity in the prediction of in-hospital mortality in ECOPD can be obtained by combined analysis of coexistence of eosinopenia and lymphocytopenia with elevated NLR. The occurrence of a such pattern is also associated with significantly longer LoH among survivors.

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Eosinopenia as a prognostic factor in patients with acute exacerbation of chronic obstructive pulmonary disease

Cited by 3 publications

References 0 publications

Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience

Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience

IL-6 modulation for COVID-19: the right patients at the right time?

Eosinopenia and neutrophil-to-lymphocyte count ratio as prognostic factors in exacerbation of COPD

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