Eosinophils and Chronic Respiratory Diseases in Hospitalized COVID-19 Patients.

Marcela Valverde-Monge,Victoria Del Pozo,Alicia Gómez-López,José A Cañas,Joaquín Sastre,Blanca Barroso,Diana Betancor,Ignacio Mahíllo-Fernández,María Jesús Rodríguez-Nieto,Laura Ortega-Martin

doi:10.3389/fimmu.2021.668074

Abstract

BackgroundStudies on the role of eosinophils in coronavirus disease 2019 (COVID-19) are scarce, though available findings suggest a possible association with disease severity. Our study analyzes the relationship between eosinophils and COVID-19, with a focus on disease severity and patients with underlying chronic respiratory diseases.MethodsWe performed a retrospective analysis of 3018 subjects attended at two public hospitals in Madrid (Spain) with PCR-confirmed SARS-CoV-2 infection from January 31 to April 17, 2020. Patients with eosinophil counts less than 0.02×109/L were considered to have eosinopenia. Individuals with chronic respiratory diseases (n=384) were classified according to their particular underlying condition, i.e., asthma, chronic pulmonary obstructive disease, or obstructive sleep apnea.ResultsOf the 3018 patients enrolled, 479 were excluded because of lack of information at the time of admission. Of 2539 subjects assessed, 1396 patients presented an eosinophil count performed on admission, revealing eosinopenia in 376 cases (26.93%). Eosinopenia on admission was associated with a higher risk of intensive care unit (ICU) or respiratory intensive care unit (RICU) admission (OR:2.21; 95%CI:1.42-3.45; p<0.001) but no increased risk of mortality (p>0.05).ConclusionsEosinopenia on admission conferred a higher risk of severe disease (requiring ICU/RICU care), but was not associated with increased mortality. In patients with chronic respiratory diseases who develop COVID-19, age seems to be the main risk factor for progression to severe disease or death.

Highlights

In December 2019, a new human coronavirus, officially denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China
intensive care unit (ICU) or respiratory intermediate care unit (RICU) admission was required for 125 individuals (5.80%), and there were 234 total deaths (10.86%), mostly among males (58.12%), with this association being statistically significant (OR = 1.45, 95% confidence interval (CI) = 1.13-1.85; p
Our analysis suggests that eosinopenia on admission could be related with severe COVID-19 disease, resulting in a higher risk of ICU/RICU admission

Summary

Introduction

In December 2019, a new human coronavirus, officially denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China. COVID-19 is a predominantly respiratory disease, with an extremely variable presentation ranging from minimal flu-like symptoms to significant hypoxia and acute respiratory distress syndrome It can affect other organs and systems [2]. In a Spanish cohort of 545 patients with severe uncontrolled asthma under biologic treatment, Rial et al [8] described a similar prevalence and severity of COVID19 between these and non-severe asthma patients This is not always the case for other chronic respiratory diseases. Available data clearly suggests a higher risk of severe COVID-19 for chronic obstructive pulmonary disease (COPD) patients, the reported prevalence seems to be similar or even lower than that of the general population [9]. Our study analyzes the relationship between eosinophils and COVID-19, with a focus on disease severity and patients with underlying chronic respiratory diseases

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