Kwok Wang Chun, Shea Yat Fung, Ho James Chung Man, Lam David Chi Leung, Tam Terence Chi Chun, Tam Anthony Raymond, Ip Mary Sau Man, Hung Ivan Fan Ngai
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong, China.
Clin Respir J. 2025 Apr;19(4):e70070. doi: 10.1111/crj.70070.
This study aims to investigate the association between elderly patients with COPD with different blood eosinophil on admission and those without COPD and the prognosis of COVID-19.
A territory-wide retrospective study was conducted to investigate the association between elderly COPD patients with different blood eosinophil on admission and the prognosis of COVID-19. Elderly patients admitted to public hospitals and community treatment facility in Hong Kong for COVID-19 from January 23, 2020, to September 31, 2021, were included in the study. Severe diseases were defined as those who develop respiratory complications, systemic complications and death.
Among the 1925 patients included, 133 had COPD. Forty had admission blood eosinophil count ≥ 150 cells/μL, and 93 had blood eosinophil count < 150 cells/μL. Patients with COPD and admission blood eosinophil count ≥ 150 cells/μL, but not those with admission blood eosinophil count < 150 cells/μL, had severe COVID-19 with the development of respiratory and systemic complications. They were more likely to develop respiratory failure (OR = 5.235, 95% CI = 2.088-13.122, p < 0.001) and require invasive mechanical ventilation (OR = 2.433, 95% CI = 1.022-5.791, p = 0.045) and intensive care unit admission (OR = 2.214, 95% CI = 1.004-4.881, p = 0.049).
Our study suggested that the blood eosinophil count on admission could have significant prognostic implications among elderly patients with COPD. Patients with COPD and admission blood eosinophil count ≥ 150 cells/μL, but not those with admission blood eosinophil count < 150 cells/μL, have significantly increased risks of developing respiratory and systemic complications from COVID-19, when compared with non-COPD patients.
本研究旨在调查入院时血嗜酸性粒细胞水平不同的老年慢性阻塞性肺疾病（COPD）患者与非COPD患者之间的关联以及新型冠状病毒肺炎（COVID-19）的预后情况。
开展一项全地区回顾性研究，以调查入院时血嗜酸性粒细胞水平不同的老年COPD患者与COVID-19预后之间的关联。纳入2020年1月23日至2021年9月31日期间在香港公立医院和社区治疗机构因COVID-19住院的老年患者。严重疾病定义为出现呼吸并发症、全身并发症及死亡的患者。
在纳入的1925例患者中，133例患有COPD。40例入院时血嗜酸性粒细胞计数≥150个/μL，93例血嗜酸性粒细胞计数<150个/μL。入院时血嗜酸性粒细胞计数≥150个/μL的COPD患者，而非入院时血嗜酸性粒细胞计数<150个/μL的患者，会发生严重的COVID-19并出现呼吸和全身并发症。他们更易发生呼吸衰竭（比值比[OR]=5.235，95%置信区间[CI]=2.088 - 13.122，p<0.001），需要有创机械通气（OR=2.433，95%CI=1.022 - 5.791，p=0.045）及入住重症监护病房（OR=2.214，95%CI=1.004 - 4.881，p=0.049）。
我们的研究表明，入院时的血嗜酸性粒细胞计数可能对老年COPD患者的预后有重要影响。与非COPD患者相比，入院时血嗜酸性粒细胞计数≥150个/μL的COPD患者，而非入院时血嗜酸性粒细胞计数<150个/μL的患者，发生COVID-19呼吸和全身并发症的风险显著增加。
