Le Borgne Pierrick, Abensur Vuillaume Laure, Alamé Karine, Lefebvre François, Chabrier Sylvie, Bérard Lise, Haessler Pauline, Gennai Stéphane, Bilbault Pascal, Lavoignet Charles-Eric
Emergency Department, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France.
INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), University of Strasbourg, 67081 Strasbourg, France.
Microorganisms. 2021 Feb 8;9(2):334. doi: 10.3390/microorganisms9020334.
Healthcare systems worldwide have been battling the ongoing COVID-19 pandemic. Eosinophils are multifunctional leukocytes implicated in the pathogenesis of several inflammatory processes including viral infections. We focus our study on the prognostic value of eosinopenia as a marker of disease severity and mortality in COVID-19 patients.
Between 1 March and 30 April 2020, we conducted a multicenter and retrospective study on a cohort of COVID-19 patients (moderate or severe disease) who were hospitalized after presenting to the emergency department (ED). We led our study in six major hospitals of northeast France, one of the outbreak's epicenters in Europe.
We have collected data from 1035 patients, with a confirmed diagnosis of COVID-19. More than three quarters of them (76.2%) presented a moderate form of the disease, while the remaining quarter (23.8%) presented a severe form requiring admission to the intensive care unit (ICU). Mean circulating eosinophils rate, at admission, varied according to disease severity ( < 0.001), yet it did not differ between survivors and non-survivors ( = 0.306). Extreme eosinopenia (=0/mm) was predictive of severity (aOR = 1.77, = 0.009); however, it was not predictive of mortality (aOR = 0.892, = 0.696). The areas under the Receiver operating characteristics (ROC) curve were, respectively, 58.5% (CI95%: 55.3-61.7%) and 51.4% (CI95%: 46.8-56.1%) for the ability of circulating eosinophil rates to predict disease severity and mortality.
Eosinopenia is very common and often profound in cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Eosinopenia was not a useful predictor of mortality; however, undetectable eosinophils (=0/mm) were predictive of disease severity during the initial ED management.
全球医疗系统一直在与持续的新冠疫情作斗争。嗜酸性粒细胞是多功能白细胞，参与包括病毒感染在内的多种炎症过程的发病机制。我们的研究重点是嗜酸性粒细胞减少作为新冠患者疾病严重程度和死亡率标志物的预后价值。
在2020年3月1日至4月30日期间，我们对一组在急诊科就诊后住院的新冠患者（中度或重度疾病）进行了多中心回顾性研究。我们在法国东北部的六家主要医院开展了研究，法国东北部是欧洲疫情的中心之一。
我们收集了1035例确诊新冠患者的数据。其中超过四分之三（76.2%）表现为中度疾病，其余四分之一（23.8%）表现为重度疾病，需要入住重症监护病房（ICU）。入院时平均循环嗜酸性粒细胞率因疾病严重程度而异（<0.001），但在幸存者和非幸存者之间没有差异（=0.306）。极端嗜酸性粒细胞减少（=0/mm）可预测疾病严重程度（调整后比值比[aOR]=1.77，=0.009）；然而，它不能预测死亡率（aOR=0.892，=0.696）。循环嗜酸性粒细胞率预测疾病严重程度和死亡率的受试者工作特征（ROC）曲线下面积分别为58.5%（95%置信区间[CI]：55.3-61.7%）和51.4%（95%CI：46.8-56.1%）。
嗜酸性粒细胞减少在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染病例中非常常见且往往很严重。嗜酸性粒细胞减少不是死亡率的有用预测指标；然而，在急诊科初始管理期间，无法检测到嗜酸性粒细胞（=0/mm）可预测疾病严重程度。
