Eosinopenia Phenotype in Patients with Coronavirus Disease 2019: A Multi-center Retrospective Study from Anhui, China

Abstract

Background: Coronavirus disease 19 has become a global unprecedented pandemic infecting more than one millon people, which is declared by WHO as a international public health emergency. Eosinopenia may predict a poor prognosis of COVID-19. However, to date, there is no detailed analysis of the clinical characteristics of COVID-19 patients with eosinopenia. . We described clincial characteristics of patients with COIVD-19 and eosinopenia phenotype. Results:The median age of patients with COVID-19 was 39 years old, and 32 (54,2%) were male. Patients with severe type had higher proportions of dyspnea (50%) and gastrointestinal symptoms (50%) compared with mild or moderate patients.Laboratory findings indicated that lower counts of lymphocyte and eosnophils were observed in patients with severe type. Cough, sputum, and fatigue were more common symptoms in eosinopenia patients compared with non-eosinopenia patients.High proportion of comorbidities was observed in eosinopenia patients. Laboratory findings indicated that lymphocyte counts (median: 101 cells/μl ) in eosinopenia patients were significantly less than those of non-eosinopenia patients (median: 167 cells/μl, p<0.001). The use of corticosteroids therapy in COVID-19 patients with : medRxiv preprint eosinopenia were notably higher than those in patients with non-eosinopenia (50% vs 13.8%, respectively, p=0.005). Compared with parameters in non-eosinopenia patients, eosinopenia patients were more inclined to have less lymphocyte counts (OR value 6.566, 95%CI[1.101-39.173], p=0.039). InterpretationEosinopenia are very common in COVID-19 patient, particularly in severe patients.Common symptoms included fever, cough, sputum, and fatigue are frequent in eosinopenia patients. Eosinopenia may represent a novel phenotype in COVID-19, which needs further investigation.

Evaluation of eosinopenia as a diagnostic and prognostic indicator in COVID‐19 infection

“…16 The median eosinophil count in COVID-19-positive patients included in our study was similar to the median counts in other studies. 3,[11][12][13][14][15] In our study, eosinopenia for early diagnosis of COVID-19 had a sensitivity of 80.68% and specificity of 100%. Li Q et al have reported that eosinopenia has a sensitivity of 74.7% and specificity of 68.7% in separating COVID-19 patients from controls.…”

“…The incidence of eosinopenia in COVID-19 patients reported in other studies varies from 50.8% to 94%. 3,[11][12][13][14][15] This difference may be attributed to differences in normal reference intervals. 3,11,15 Although 0 eosinophils have been reported in COVID-19 patients, 12,15 the percentage of patients presenting with 0 eosinophil count has been reported only in much smaller studies.…”

“…3,[11][12][13][14][15] This difference may be attributed to differences in normal reference intervals. 3,11,15 Although 0 eosinophils have been reported in COVID-19 patients, 12,15 the percentage of patients presenting with 0 eosinophil count has been reported only in much smaller studies. 3,16 In a study which included 12 COVID-19 patients, 25% of the patients presented with 0 eosinophils.…”

Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and eosinophils correlation with high-resolution computer tomography severity score in COVID-19 patients

“…Interestingly, PLR has in COVID -19 patients a better correlation with classical inflammation makes than in other diseases. This could be the consequence of coagulation changes that appear in COVID-19 [22,26,27]. Peripheral bloodcells, eosinophils, in particular, seem to help predict severe disease as they tend to accumulate in infected tissues "to fight" the virus.…”

A Pathophysiological Perspective on COVID-19's Lethal Complication: From Viremia to Hypersensitivity Pneumonitis-like Immune Dysregulation

“…Mast cells were 1000-fold higher in BAL of HP patients, and analysis of excessive amounts of histamine in the fluid suggested that the lavage procedure may promote mast cell degranulation [ 29 ]. In this vein, eosinopenia in severe SARS-CoV-2 cases and may suggest migration to the lungs [ 30 ]. Autopsy has confirmed eosinophils in the lung, and restoration of eosinophil counts in the blood are predictive of SARS-CoV-2 resolution by also testing negative via reverse transcription polymerase chain reaction (RT-PCR) signifying viral clearance [ 31 32 ].…”