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. 2023 May;135(9-10):235-243.
doi: 10.1007/s00508-023-02180-w. Epub 2023 Apr 24.

Investigating the role of obstructive pulmonary diseases and eosinophil count at admission on all-cause mortality in SARS-CoV-2 patients : A single center registry-based retrospective cohort study

Grgur Salai  1 , Hrvoje Vrazic  2   3 , Ivona Kovacevic  1 , Linda Malnar Janes  1 , Ivan Marasovic  1 , Darjan Ranilovic  1 , Damir Vukoja  1 , Marina Zelenika Margeta  1 , Ivana Huljev-Sipos  1 , Kristina Lalic  1 , Marko Spoljaric  1 , Jasna Tekavec-Trkanjec  1 , Mirna Vergles  1 , Marko Lucijanic  4   5 , Ivica Luksic  6   5 , Divo Ljubicic  7   8
Affiliations

Investigating the role of obstructive pulmonary diseases and eosinophil count at admission on all-cause mortality in SARS-CoV-2 patients : A single center registry-based retrospective cohort study

Grgur Salai et al. Wien Klin Wochenschr. 2023 May.

Abstract

Introduction: The impact of asthma and chronic obstructive pulmonary disease (COPD) in the setting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) infection is not clearly defined. Blood eosinophil count is a standard diagnostic test which, according to the previously published literature, might have a potential prognostic role on mortality in patients with SARS-CoV‑2 infection.

Aim: To investigate the potential prognostic value of peripheral blood eosinophil count on all-cause mortality of patients hospitalized with SARS-CoV‑2 infection, as well as to assess the impact of asthma or COPD premorbidity on all-cause mortality.

Material and methods: We conducted a retrospective registry-based cohort study. Survival analysis was performed by employing the Cox proportional hazards regression model at 30 days of follow-up. Prognostic value of eosinophil count on all-cause mortality was assessed using receiver-operating characteristic (ROC) curve analysis.

Results: A total of 5653 participants were included in the study. Our model did not reveal that pre-existing asthma or COPD is a statistically significant covariate for all-cause mortality but, indicated that higher eosinophil count at admission might have a protective effect (hazard ratio, HR 0.13 (95% confidence interval, CI 0.06-0.27), p = 0.0001). ROC curve analysis indicates cut-off value of 20 cells/mm3 (81% specificity; 30.9% sensitivity).

Conclusion: Our results indicate that eosinophil count at hospital admission might have a potential prognostic role for all-cause mortality at 30 days of follow-up; however this was not demonstrated for pre-existing obstructive lung diseases.

Keywords: Asthma; COVID-19; Chronic obstructive pulmonary disease; Eosinophils; Retrospective cohort study.

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Conflict of interest statement

G. Salai, H. Vrazic, I. Kovacevic, L.M. Janes, I. Marasovic, D. Ranilovic, D. Vukoja, M. Zelenika Margeta, I. Huljev–Sipos, K. Lalic, M. Spoljaric, J. Tekavec-Trkanjec, M. Vergles, M. Lucijanic, I. Luksic and D. Ljubicic declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart depicting the selection process based on the eligibility criteria. ACO asthma/chronic obstructive disease overlap; COPD chronic obstructive disease
Fig. 2
Fig. 2
Kaplan Meier survival curves at 30 days of follow-up: a for the entire cohort; b per subgroups. ACO concomitant asthma and chronic obstructive pulmonary disease; COPD chronic obstructive disease; NOD no obstructive disease
Fig. 3
Fig. 3
Survival probability extrapolated from the plotted Cox proportional hazards regression model plotted for 30 days of follow-up. a Survival at mean of covariates; b survival for each subgroup. ACO concomitant asthma and chronic obstructive pulmonary disease; COPD chronic obstructive disease; NOD no obstructive disease
Fig. 4
Fig. 4
Receiver-operating characteristic (ROC) curve for assessing the prognostic ability of eosinophil count at admission (expressed as number * 109 per L) on all-cause mortality at 30 days of follow-up
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