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. 2021 Feb;76(2):471-482.
doi: 10.1111/all.14465. Epub 2020 Jul 13.

The role of peripheral blood eosinophil counts in COVID-19 patients

Guogang Xie  1 , Fengming Ding  1 , Lei Han  1 , Dongning Yin  1 , Hongzhou Lu  2 , Min Zhang  1
Affiliations

The role of peripheral blood eosinophil counts in COVID-19 patients

Guogang Xie et al. Allergy. 2021 Feb.

Abstract

Background: Coronavirus disease 2019 (COVID-19) emerged in Wuhan city and rapidly spread globally outside China. We aimed to investigate the role of peripheral blood eosinophil (EOS) as a marker in the course of the virus infection to improve the efficiency of diagnosis and evaluation of COVID-19 patients.

Methods: 227 pneumonia patients who visited the fever clinics in Shanghai General Hospital and 97 hospitalized COVID-19 patients admitted to Shanghai Public Health Clinical Center were involved in a retrospective research study. Clinical, laboratory, and radiologic data were collected. The trend of EOS level in COVID-19 patients and comparison among patients with different severity were summarized.

Results: The majority of COVID-19 patients (71.7%) had a decrease in circulating EOS counts, which was significantly more frequent than other types of pneumonia patients. EOS counts had good value for COVID-19 prediction, even higher when combined with neutrophil-to-lymphocyte ratio. Patients with low EOS counts at admission were more likely to have fever, fatigue, and shortness of breath, with more lesions in chest CT and radiographic aggravation, and longer length of hospital stay and course of disease than those with normal EOS counts. Circulating EOS level gradually increased over the time, and was synchronous with the improvement in chest CT (12 days vs 13 days, P = .07), later than that of body temperature (12 days vs 10 days, P = .014), but earlier than that of the negative conversion of nucleic acid assays (12 days vs 17 days, P = .001).

Conclusion: Peripheral blood EOS counts may be an effective and efficient indicator in diagnosis, Evaluation, and prognosis monitoring of COVID-19 patients.

Keywords: COVID-19; diagnosis; peripheral blood eosinophils; pneumonia; prognosis.

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Conflict of interest statement

None of the authors have any conflict of interest to declare.

Figures

Figure 1
Figure 1
schematic overview of the study design (unmarked)
Figure 2
Figure 2
ROC curve analysis was performed to evaluate the diagnostic ability of COVID‐19 (unmarked). The EOS counts (green line) had AUC of 0.74, and the cutoff value was 0.015; NLR (blue line) had AUC of 0.73, and the cutoff value was 2.425; the combination of the EOS counts and NLR (yellow line) has a better diagnosis value (AUC = 0.82) for COVID‐19 than either indicator
Figure 3
Figure 3
Changes in peripheral blood EOS in the course of disease (unmarked). A. Change in peripheral blood EOS counts and the incidence of EOS reduction in the course of disease. B. Change in peripheral blood EOS and lymphocyte counts in the course of disease. C. Change in peripheral blood EOS counts of nonsevere and severe patients in the course of disease. D‐F. Comparison of recovery time of EOS counts with that of chest CT, body temperature, and negative conversion of nucleic acid assays. G‐I. Correlation analysis of recovery time of EOS counts with that of chest CT, body temperature, and negative conversion of nucleic acid assays. J. Comparison of the incidence of the recovery of body temperature, improvement of chest CT, and EOS counts in the course of disease
See this image and copyright information in PMC

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