María Mateos González1, Elena Sierra Gonzalo2, Irene Casado Lopez1, Francisco Arnalich Fernández3, José Luis Beato Pérez4, Daniel Monge Monge5, Juan Antonio Vargas Núñez6, Rosa García Fenoll7, Carmen Suárez Fernández8, Santiago Jesús Freire Castro9, Manuel Mendez Bailon10, Isabel Perales Fraile11, Manuel Madrazo12, Paula Maria Pesqueira Fontan13, Jeffrey Oskar Magallanes Gamboa14, Andrés González García15, Anxela Crestelo Vieitez16, Eva María Fonseca Aizpuru17, Asier Aranguren Arostegui18, Ainara Coduras Erdozain19, Carmen Martinez Cilleros20, Jose Loureiro Amigo21, Francisco Epelde22, Carlos Lumbreras Bermejo23, Juan Miguel Antón Santos1. 1. Internal Medicine Department, Infanta Cristina University Hospital, 28981 Parla, Spain. 2. Pathology Department, Infanta Cristina University Hospital, 28981 Parla, Spain. 3. Internal Medicine Department, La Paz University Hospital, 28046 Madrid, Spain. 4. Internal Medicine Department, Albacete University Hospital Complex, 02008 Albacete, Spain. 5. Internal Medicine Department, Segovia Hospital Complex, 40002 Segovia, Spain. 6. Internal Medicine Department, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain. 7. Internal Medicine Department, Miguel Servet Hospital, 50009 Zaragoza, Spain. 8. Internal Medicine Department, La Princesa University Hospital, 28006 Madrid, Spain. 9. Internal Medicine Department, A Coruña University Hospital, 15006 A Coruña, Spain. 10. Internal Medicine Department, Clinico San Carlos Hospital, 28040 Madrid, Spain. 11. Internal Medicine Department, Infanta Sofía Hospital, 28703 San Sebastián de los Reyes, Spain. 12. Internal Medicine Department, Dr. Peset University Hospital, 46017 Valencia, Spain. 13. Internal Medicine Department, Santiago Clinical Hospital, 15706 Santiago de Compostela, Spain. 14. Internal Medicine Department, Nuestra Señora del Prado Hospital, 45600 Talavera de la Reina, Spain. 15. Internal Medicine Department, Ramón y Cajal University Hospital, 28034 Madrid, Spain. 16. Internal Medicine Department, Royo Villanova Hospital, 50015 Zaragoza, Spain. 17. Internal Medicine Department, Cabueñes Hospital, 33394 Gijón, Spain. 18. Internal Medicine Department, Urduliz Alfredo Espinosa Hospital, 48610 Urdúliz, Spain. 19. Internal Medicine Department, Santa Marina Hospital, 48004 Bilbao, Spain. 20. Internal Medicine Department, HLA Moncloa Hospital, 28008 Madrid, Spain. 21. Internal Medicine Department, Moisès Broggi Hospital, 08970 Sant Joan Despí, Spain. 22. Internal Medicine Department, Parc Tauli Hospital, 08208 Sabadell, Spain. 23. Internal Medicine Department, 12 de Octubre University Hospital, 28041 Madrid, Spain.
Abstract
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%, p = 0.000) and ICU admission (5.4% vs. 10.8%, p = 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.
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%, p = 0.000) and ICU admission (5.4% vs. 10.8%, p = 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.
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