The role of peripheral blood eosinophil counts in COVID‐19 patients

Abstract

Background Coronavirus disease 2019 (COVID‐19) emerged in Wuhan city and rapidly spread globally outside China. We aimed to investigate the role of peripheral blood eosinophil (EOS) as a marker in the course of the virus infection to improve the efficiency of diagnosis and evaluation of COVID‐19 patients. Methods 227 pneumonia patients who visited the fever clinics in Shanghai General Hospital and 97 hospitalized COVID‐19 patients admitted to Shanghai Public Health Clinical Center were involved in a retrospective research study. Clinical, laboratory, and radiologic data were collected. The trend of EOS level in COVID‐19 patients and comparison among patients with different severity were summarized. Results The majority of COVID‐19 patients (71.7%) had a decrease in circulating EOS counts, which was significantly more frequent than other types of pneumonia patients. EOS counts had good value for COVID‐19 prediction, even higher when combined with neutrophil‐to‐lymphocyte ratio. Patients with low EOS counts at admission were more likely to have fever, fatigue, and shortness of breath, with more lesions in chest CT and radiographic aggravation, and longer length of hospital stay and course of disease than those with normal EOS counts. Circulating EOS level gradually increased over the time, and was synchronous with the improvement in chest CT (12 days vs 13 days, P = .07), later than that of body temperature (12 days vs 10 days, P = .014), but earlier than that of the negative conversion of nucleic acid assays (12 days vs 17 days, P = .001). Conclusion Peripheral blood EOS counts may be an effective and efficient indicator in diagnosis, Evaluation, and prognosis monitoring of COVID‐19 patients.

White blood cells and severe COVID-19: a Mendelian randomization study

“…retrospective and prospective observational studies [12,15,31,32,[35][36][37]. There are also reports that eosinophil remains stable in severe COVID-19 patients [13,29,38,39].…”

Altered blood cell traits underlie a major genetic locus of severe COVID-19

“…The pattern of eosinophil is less well-established. Some studies observed diminished and even undetectable eosinophil counts (i.e., eosinopenia) in COVID-19 patients 26,27,[31][32][33][34] , and it was also shown that eosinophil counts are positively associated with lymphocyte counts in both severe and non-severe cases 34 .…”

The Possible Dual Role of the ACE2 Receptor in Asthma and Coronavirus (SARS-CoV2) Infection

“…Eosinophils may also play a larger role in COVID-19, as non-asthmatic patients with COVID-19 who present an absence of eosinophils in the first day of hospitalization have a worst prognose than non-asthmatic patients with eosinophils (Tanni et al, 2020 ). Another study suggested that eosinophil count in peripheral blood has prognostic value, as patients with a low number of eosinophils were more likely to exhibit shortness of breath and require longer hospitalization time (Xie et al, 2020 ). An increase in eosinophils is associated with COVID-19 improvement and hospital release (Liu et al, 2020 ; Xie et al, 2020 ).…”