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. 2023 May 22;23(1):177.
doi: 10.1186/s12890-023-02473-w.

Circulating eosinophils associated with responsiveness to COVID-19 vaccine and the disease severity in patients with SARS-CoV-2 omicron variant infection

Zhuxian Zhu #  1 , Jixu Cai #  2 , Qiang Tang #  3 , Yin-Yuan Mo #  4 , Tiantian Deng #  5 , Xiaoyu Zhang #  6 , Ke Xu  7 , Beishou Wu  7 , Haicheng Tang  8 , Ziqiang Zhang  9
Affiliations

Circulating eosinophils associated with responsiveness to COVID-19 vaccine and the disease severity in patients with SARS-CoV-2 omicron variant infection

Zhuxian Zhu et al. BMC Pulm Med. .

Abstract

Objective: This study aimed to investigate the longitudinal circulating eosinophil (EOS) data impacted by the COVID-19 vaccine, the predictive role of circulating EOS in the disease severity, and its association with T cell immunity in patients with SARS-CoV-2 Omicron BA.2 variant infection in Shanghai, China.

Methods: We collected a cohort of 1,157 patients infected with SARS-CoV-2 Omicron/BA.2 variant in Shanghai, China. These patients were diagnosed or admitted between Feb 20, 2022, and May 10, 2022, and were classified as asymptomatic (n = 705), mild (n = 286) and severe (n = 166) groups. We compiled and analyzed data of patients' clinical demographic characteristics, laboratory findings, and clinical outcomes.

Results: COVID-19 vaccine reduced the incidence of severe cases. Severe patients were shown to have declined peripheral blood EOS. Both the 2 doses and 3 doses of inactivated COVID-19 vaccines promoted the circulating EOS levels. In particular, the 3rd booster shot of inactivated COVID-19 vaccine was shown to have a sustained promoting effect on circulating EOS. Univariate analysis showed that there was a significant difference in age, underlying comorbidities, EOS, lymphocytes, CRP, CD4, and CD8 T cell counts between the mild and the severe patients. Multivariate logistic regression analysis and ROC curve analysis indicate that circulating EOS (AUC = 0.828, p = 0.025), the combination of EOS and CD4 T cell (AUC = 0.920, p = 0.017) can predict the risk of disease severity in patients with SARS-CoV-2 Omicron BA.2 variant infection.

Conclusions: COVID-19 vaccine promotes circulating EOS and reduces the risk of severe illness, and particularly the 3rd booster dose of COVID-19 vaccine sustainedly promotes EOS. Circulating EOS, along with T cell immunity, may have a predictive value for the disease severity in SARS-CoV-2 Omicron infected patients.

Keywords: COVID-19 vaccine; Disease severity; Eosinophil (EOS); Omicron variant; SARS-CoV-2; T cell immunity.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic of study design EOS, Eosinophils; COVID-19, 2019 coronavirus disease
Fig. 2
Fig. 2
Effects of age and the underlying comorbidities on circulating EOS, and the correlation between circulating EOS and the CD4 or CD8 T cells HBP, high blood pressure; CAD, Coronary artery disease; DM, Diabetes mellitus
Fig. 3
Fig. 3
Effects of the inactivated COVID-19 vaccine on circulating EOS. The promoting effect of 2 doses or 3 doses of COVID-19 vaccine on circulating EOS in the asymptomatic (Fig. 3A, B and E); The effect of COVID-19 vaccines from different manufacturers (Fig. 3C and D); The role of COVID-19 vaccine on CRP levels (Fig. 3F). Non-vaccine: Not vaccinated; Days (0–90), Days (90–150), 150 days later: Time from the last anti-COVID-19 vaccine dose to the onset of symptoms
Fig. 4
Fig. 4
ROC curve analysis of circulating EOS for the disease severity EOS, Eosinophils; ROC: Receiver Operating Characteristics; Combined: combination of EOS and CD4 T cell
See this image and copyright information in PMC

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