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The Dynamic Changes of Eosinophils and Its Potential Predictive Value in Patients with COVID-19
15 Pages Posted: 30 Apr 2020
More...Abstract
Background: Since December, 2019, the outbreak of COVID-19, epidemiological and clinical characteristics of patients with COVID-19 have been reported to be a feature of normal white blood cell count, lymphopenia and eosinopenia. But there has been no systemic study on eosinophil count reduction and its implication in patients with COVID-19.
Methods: In this retrospective, single centre study, we included all available inpatients of COVID-19 with nucleic acid test positive confirmation and corticosteroid-naïve when admission in Renmin Hospital of Wuhan University (Wuhan, China) from Jan 28 to Mar 26, 2020. Demographic, clinical, treatment, and laboratory data were extracted from electronic medical records and dynamic changes of % eosinophil count was compared between survivors and non-survivors, patients of general type or severe type and those of critical type. We described the general distribution of eosinophil count in patients of COVID-19 and correlated LOER (length of eosinophil count return) with LOS (length of hospital stay).
Findings: 453 patients were included in this study, of whom 45 died in hospital and 408 were discharged, which were classified as general type, severe type and critical type. Eosinophil count at illness onset fell below 0.4% (the lower normal limit) in 302 (66.7%) of the patients and differed between survivors and non-survivors, the general type or severe type and the critical type. LOER correlated with LOS significantly (r=0·14, 95%CI: 0·04 to 0·24, p<0·01). Eosinophil count returned to normal much quicker in general type or severe type than in critical type, but returned very slowly or even could not return for non-survivals comparing to survivals.
Interpretation: Peripheral blood eosinophil count was markedly reduced in majority of the patients infected with SARS-CoV-2 at their illness onset. LOER correlates to LOS. A persistent low eosinophil count maybe a predictor of poor prognosis.
Funding Statement: None.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: Ethic approval was obtained from the Research Ethics Committee of the Renmin Hospital of Wuhan University, Wuhan, China (approval number: WDRY2020-K041). The Research Ethics Committee waived the requirement of informed consent before the study started because of the urgent need to collect epidemiological and clinical data. We analyzed all the data anonymously.
Keywords: COVID-19, SARS-CoV-2, eosinophil, prognosis, white blood cell count, infectious disease
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