Pierrick Le Borgne1,2,3, Laure Abensur Vuillaume3,4, Karine Alamé1,3, François Lefebvre5, Sylvie Chabrier1, Lise Bérard6, Pauline Haessler7, Stéphane Gennai8, Pascal Bilbault1,2,3, Charles-Eric Lavoignet3,9. 1. Emergency Department, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France. 2. 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. 3. CREMS Network (Clinical Research in Emergency Medicine and Sepsis), 67022 Wolfisheim, France. 4. Emergency Department, Regional Hospital of Metz-Thionville, 57530 Ars-Laquenexy, France. 5. Department of Public Health, University Hospital of Strasbourg, 67091 Strasbourg, France. 6. Emergency Department, Haguenau Hospital, 67500 Haguenau, France. 7. Emergency Department, Colmar Hospital, 68000 Colmar, France. 8. Emergency Department, Reims University Hospital, 51100 Reims, France. 9. Emergency Department, Hôpital Nord Franche Comté, 90400 Trévenans, France.
Abstract
INTRODUCTION: 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. METHODS: 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. RESULTS: 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 (p < 0.001), yet it did not differ between survivors and non-survivors (p = 0.306). Extreme eosinopenia (=0/mm3) was predictive of severity (aOR = 1.77, p = 0.009); however, it was not predictive of mortality (aOR = 0.892, p = 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. CONCLUSION: 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/mm3) were predictive of disease severity during the initial ED management.
INTRODUCTION: 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-19patients. METHODS: Between 1 March and 30 April 2020, we conducted a multicenter and retrospective study on a cohort of COVID-19patients (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. RESULTS: 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 (p < 0.001), yet it did not differ between survivors and non-survivors (p = 0.306). Extreme eosinopenia (=0/mm3) was predictive of severity (aOR = 1.77, p = 0.009); however, it was not predictive of mortality (aOR = 0.892, p = 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. CONCLUSION: 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/mm3) were predictive of disease severity during the initial ED management.
Authors: Brandon Michael Henry; Maria Helena Santos de Oliveira; Stefanie Benoit; Mario Plebani; Giuseppe Lippi Journal: Clin Chem Lab Med Date: 2020-06-25 Impact factor: 3.694
Authors: Joe G Zein; Ronald Strauss; Amy H Attaway; Bo Hu; Alex Milinovich; Nesreen Jawhari; Soulaima S Chamat; Victor E Ortega Journal: J Allergy Clin Immunol Pract Date: 2022-01-13