嗜酸性粒细胞恢复在COVID-19中的预后价值：一项针对西班牙医院住院患者的多中心回顾性队列研究
The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort Study on Patients Hospitalised in Spanish Hospitals.
作者信息
Mateos González María, Sierra Gonzalo Elena, Casado Lopez Irene, Arnalich Fernández Francisco, Beato Pérez José Luis, Monge Monge Daniel, Vargas Núñez Juan Antonio, García Fenoll Rosa, Suárez Fernández Carmen, Freire Castro Santiago Jesús, Mendez Bailon Manuel, Perales Fraile Isabel, Madrazo Manuel, Pesqueira Fontan Paula Maria, Magallanes Gamboa Jeffrey Oskar, González García Andrés, Crestelo Vieitez Anxela, Fonseca Aizpuru Eva María, Aranguren Arostegui Asier, Coduras Erdozain Ainara, Martinez Cilleros Carmen, Loureiro Amigo Jose, Epelde Francisco, Lumbreras Bermejo Carlos, Antón Santos Juan Miguel
机构信息
Internal Medicine Department, Infanta Cristina University Hospital, 28981 Parla, Spain.
Pathology Department, Infanta Cristina University Hospital, 28981 Parla, Spain.
出版信息
J Clin Med. 2021 Jan 15;10(2):305. doi: 10.3390/jcm10020305.
OBJECTIVES
A decrease in blood cell counts, especially lymphocytes and eosinophils, has been described in patients with serious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), but there is no knowledge of their potential role of the recovery in these patients' prognosis. This article aims to analyse the effect of blood cell depletion and blood cell recovery on mortality due to COVID-19.
DESIGN
This work was a retrospective, multicentre cohort study of 9644 hospitalised patients with confirmed COVID-19 from the Spanish Society of Internal Medicine's SEMI-COVID-19 Registry.
SETTING
This study examined patients hospitalised in 147 hospitals throughout Spain.
PARTICIPANTS
This work analysed 9644 patients (57.12% male) out of a cohort of 12,826 patients ≥18 years of age hospitalised with COVID-19 in Spain included in the SEMI-COVID-19 Registry as of 29 May 2020.
MAIN OUTCOME MEASURES
The main outcome measure of this work is the effect of blood cell depletion and blood cell recovery on mortality due to COVID-19. Univariate analysis was performed to determine possible predictors of death, and then multivariate analysis was carried out to control for potential confounders.
RESULTS
An increase in the eosinophil count on the seventh day of hospitalisation was associated with a better prognosis, including lower mortality rates (5.2% vs. 22.6% in non-recoverers, OR 0.234; 95% CI, 0.154 to 0.354) and lower complication rates, especially regarding the development of acute respiratory distress syndrome (8% vs. 20.1%, = 0.000) and ICU admission (5.4% vs. 10.8%, = 0.000). Lymphocyte recovery was found to have no effect on prognosis. Treatment with inhaled or systemic glucocorticoids was not found to be a confounding factor.
CONCLUSION
Eosinophil recovery in patients with COVID-19 who required hospitalisation had an independent prognostic value for all-cause mortality and a milder course.
目的
已有研究表明，严重的2019冠状病毒病（SARS-CoV-2）患者的血细胞计数会下降，尤其是淋巴细胞和嗜酸性粒细胞，但尚不清楚它们在这些患者预后恢复中的潜在作用。本文旨在分析血细胞减少和血细胞恢复对新型冠状病毒肺炎（COVID-19）所致死亡率的影响。
设计
本研究为一项回顾性、多中心队列研究，研究对象为来自西班牙内科协会SEMI-COVID-19登记处的9644例确诊为COVID-19的住院患者。
背景
本研究调查了西班牙147家医院收治的患者。
参与者
本研究分析了截至2020年5月29日纳入SEMI-COVID-19登记处的西班牙12826例≥18岁因COVID-19住院患者中的9644例（男性占57.12%）。
主要观察指标
本研究的主要观察指标是血细胞减少和血细胞恢复对COVID-19所致死亡率的影响。进行单因素分析以确定可能的死亡预测因素，然后进行多因素分析以控制潜在的混杂因素。
结果
住院第7天嗜酸性粒细胞计数增加与较好的预后相关，包括较低的死亡率（未恢复者为5.2%，恢复者为22.6%，比值比为0.234；95%置信区间为0.154至0.354）和较低的并发症发生率，尤其是急性呼吸窘迫综合征的发生率（8%对20.1%，P = 0.000）和入住重症监护病房的发生率（5.4%对10.8%，P = 0.000）。发现淋巴细胞恢复对预后无影响。未发现吸入或全身使用糖皮质激素治疗是一个混杂因素。
结论
对于需要住院治疗的COVID-19患者，嗜酸性粒细胞恢复对全因死亡率和病情较轻的病程具有独立的预后价值。
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