Ospedale Alessandro Manzoni, Lecco, Italy.
Università degli Studi di Milano, Milan, Italy.
Int J Clin Pract. 2021 Jul;75(7):e14047. doi: 10.1111/ijcp.14047. Epub 2021 Feb 5.
Viral pneumonia is the most relevant clinical presentation of COVID-19 which may lead to severe acute respiratory syndrome and even death. Eosinopenia was often noticed in patients with COVID-19 pneumonia, but its role is poorly investigated. The aim of the present study was to investigate the characteristics and clinical outcomes of patients with COVID-19 pneumonia and eosinopenia.
We revised the records of consecutive patients with COVID-19 pneumonia admitted to our ER-COVID-19 area in order to compare clinical characteristics and outcomes of patients with and without eosinopenia. We considered the following clinical outcomes: 4-weeks survival; need for intensive respiratory support; and hospital discharge.
Out of first 107 consecutive patients with pneumonia and a positive COVID-19 nasopharyngeal swab, 75 patients showed undetectable eosinophil count (absolute eosinopenia). At 4 weeks, 38 patients (38.4%) had required intensive respiratory treatment, 25 (23.4%) deceased and 42 (39.2%) were discharged. Compared with patients without absolute eosinopenia, patients with absolute eosinopenia showed higher need of intensive respiratory treatment (49.3% vs 13.3%, P < .001), higher mortality (30.6% vs 6.2%, P .006) and lower rate of hospital discharge (28% vs 65.6%, P < .001). Binary logistic regression analyses including neutrophil, lymphocyte, eosinophil, basophil and monocyte counts showed that absolute eosinopenia was an independent factor associated with 4-weeks mortality, need for intensive respiratory support and hospital discharge.
Absolute eosinopenia is associated with clinical outcomes in patients with COVID-19 pneumonia and might be used as a marker to discriminate patients with unfavourable prognosis.
病毒性肺炎是 COVID-19 最相关的临床特征，可导致严重急性呼吸综合征，甚至死亡。COVID-19 肺炎患者常出现嗜酸性粒细胞减少，但对其作用研究甚少。本研究旨在探讨 COVID-19 肺炎伴嗜酸性粒细胞减少患者的特征和临床结局。
我们回顾性分析了连续收治于我院急诊 COVID-19 病房的 COVID-19 肺炎患者的病历，比较了嗜酸性粒细胞减少和不减少患者的临床特征和结局。我们考虑了以下临床结局：4 周生存；需要强化呼吸支持；以及出院。
在 107 例连续的肺炎患者中，有 75 例 COVID-19 鼻咽拭子检测阳性且嗜酸性粒细胞计数不可检测（绝对嗜酸性粒细胞减少）。4 周时，38 例（38.4%）需要强化呼吸治疗，25 例（23.4%）死亡，42 例（39.2%）出院。与无绝对嗜酸性粒细胞减少的患者相比，绝对嗜酸性粒细胞减少的患者需要强化呼吸治疗的比例更高（49.3%比 13.3%，P<.001），死亡率更高（30.6%比 6.2%，P<.006），出院率更低（28%比 65.6%，P<.001）。包括中性粒细胞、淋巴细胞、嗜酸性粒细胞、嗜碱性粒细胞和单核细胞计数的二元逻辑回归分析表明，绝对嗜酸性粒细胞减少是与 4 周死亡率、需要强化呼吸支持和出院相关的独立因素。
绝对嗜酸性粒细胞减少与 COVID-19 肺炎患者的临床结局相关，可能可作为预测不良预后的标志物。
