Investigating the role of obstructive pulmonary diseases and eosinophil count at admission on all-cause mortality in SARS-CoV-2 patients

Abstract

Introduction The impact of asthma and chronic obstructive pulmonary disease (COPD) in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) infection is not clearly defined. Blood eosinophil count is a standard diagnostic test which, according to the previously published literature, might have a potential prognostic role on mortality in patients with SARS-CoV‑2 infection. Aim To investigate the potential prognostic value of peripheral blood eosinophil count on all-cause mortality of patients hospitalized with SARS-CoV‑2 infection, as well as to assess the impact of asthma or COPD premorbidity on all-cause mortality. Material and methods We conducted a retrospective registry-based cohort study. Survival analysis was performed by employing the Cox proportional hazards regression model at 30 days of follow-up. Prognostic value of eosinophil count on all-cause mortality was assessed using receiver-operating characteristic (ROC) curve analysis. Results A total of 5653 participants were included in the study. Our model did not reveal that pre-existing asthma or COPD is a statistically significant covariate for all-cause mortality but, indicated that higher eosinophil count at admission might have a protective effect (hazard ratio, HR 0.13 (95% confidence interval, CI 0.06–0.27), p = 0.0001). ROC curve analysis indicates cut-off value of 20 cells/mm 3 (81% specificity; 30.9% sensitivity). Conclusion Our results indicate that eosinophil count at hospital admission might have a potential prognostic role for all-cause mortality at 30 days of follow-up; however this was not demonstrated for pre-existing obstructive lung diseases.

Meta-analysis of peripheral blood eosinophils in clinical testing of chronic obstructive pulmonary disease patients

“…Therefore, COPD patients with high EOS levels have higher immune function, faster recovery, shorter hospital stay, lower mortality and readmission rates. Research has shown that the level of EOS at patient admission may have a potential predictive effect on all-cause mortality at 30 days of follow-up [ 40 ]. In addition, research has been conducted on the use of Benralizumab to prevent the deterioration of COPD and reduce mortality [ 41 ].…”