Peripheral Blood Eosinophil as a Biomarker in Outcomes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Authors Wu HX, Zhuo KQ, Cheng DY
Received 11 August 2019
Accepted for publication 10 December 2019
Published 24 December 2019 Volume 2019:14 Pages 3003—3015
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Editor who approved publication: Prof. Dr. Chunxue Bai
Hong-Xia Wu,1,* Kai-Quan Zhuo,2,* De-Yun Cheng1,*
1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Department of Neurosurgery, Suining Municipal Hospital of TCM, Suining, People’s Republic of China
*These authors contributed equally to this work
Correspondence: De-Yun Cheng
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan, People’s Republic of China
Purpose: Mounting evidence suggests that eosinophil levels correlate with the effects of therapy and phenotype for chronic obstructive pulmonary disease (COPD). This study aimed to clarify the relationship between eosinophil levels and clinical outcomes in patients with acute exacerbation of COPD (AECOPD).
Methods: A prospective, multicenter, observational cohort study was performed in three teaching hospitals. Patients were grouped by quartile percentage (0, 0.7, 2.55) and absolute blood eosinophils count (0, 0.05×109/L, 0.17×109/L) and divided into four numbered groups ranked from low to high.
Results: The study included 493 AECOPD patients. In the percentile-ranked groups, patients in Group 1 experienced significantly longer hospital stays, higher rates of both noninvasive mechanical ventilation (NIMV), and heart failure than those in Group 4 (12 days vs 10 days, p = 0.005; 29.5% vs 23.6%, p = 0.007; 48.4% vs 28.5%, p = 0.001). Group 1 also had higher frequencies of respiratory failure and pulmonary heart disease compared to Groups 3 and 4 (54.8% vs 34.8%, p = 0.002; 54.8% vs 35%, p = 0.003). In the absolute count-ranked groups, patients in Group 1 had significantly higher rates of NIMV than those in Group 3 (41.1% vs 21.7%, p = 0.001), had higher rates of heart failure, respiratory failure, and pulmonary heart disease than those in Group 3 and 4 (48.1% vs 30.2%, p = 0.003; 48.1% vs 30.4%, p = 0.005; 50.8% vs 32.2%, p = 0.004; 50.8% vs 34.1%, p = 0.008; 51.9% vs 34.1%, p = 0.004; 51.9% vs 33%, p = 0.003). There were outcome differences among the admitting hospital of stays in the absolute count groups (p = 0.002), but the differences were not significant in a pairwise comparison. The proportion of ICU admissions and mortality was different in two cohorts with no difference in a pairwise comparison.
Conclusion: Patients with lower eosinophil counts experienced poorer clinical outcomes. Eosinophil levels may be a helpful marker to predict outcomes in AECOPD.
Keywords: eosinophils, chronic obstructive pulmonary disease, exacerbation, biomarkers, mortality
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