Infectious Disease

Eosinophilia in sufferers with bronchial asthma might shield towards extreme COVID-19

February 09, 2021

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Eosinophilia may be an important predictor of COVID-19-associated hospitalization and decreased mortality in patients with asthma, as published in the Journal of Allergy and Clinical Immunology: In Practice.

“To the best of our knowledge, this is the first study to demonstrate a potential protective function of eosinophilia in asthma patients with COVID-19,” Dr. Denisa Ferastraoaru, Assistant Professor in the Medical Department of Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, New York and colleagues wrote. “The exact role of eosinophils in SARS-CoV-2 infection is unknown.”

The retrospective study included 951 patients with asthma and confirmed COVID-19 (mean age 60.5 years; 31.8% men) from March to April 2020. The researchers analyzed comorbidities such as diabetes, high blood pressure, heart failure and chronic kidney disease, laboratory results and mortality rates during of hospitalization.

A total of 737 (77.5%) patients attended the ED, 581 (78.8%; mean age 64.9 years; 35.5% men) of the patients admitted to the ED.

Patients with previously measured mean absolute eosinophil counts of at least 150 cells / µl had a lower probability of hospitalization (OR = 0.46; 95% CI, 0.21-0.98; P = 0.04). Risk factors for hospitalization included heart failure, chronic kidney disease, and COPD.

One hundred and four hospitalized patients with asthma had hospitalized absolute eosinophil counts of at least 150 cells / µL. These patients had a lower likelihood of in-hospital mortality compared to patients with an absolute eosinophil count of less than 150 cells / µl (9.6% versus 25.8%; OR = 0.006; 95% CI, 0.0001-0, 64; P = 0.03)) and hospitalized patients with asthma had a higher mean absolute eosinophil count before admission (237 cells / µL vs. 147 cells / µL; P = 0.001).

In patients with asthma but without associated comorbidities such as diabetes or high blood pressure, the mortality rate was similar to that in patients without asthma or comorbidities (18.4% and 13.5%; OR = 1.41; 95% CI, 0.28- 7.12; P. = 0.6).

“More prospective and mechanistic studies are needed to examine the precise role of eosinophils in COVID-19 mortality, as well as the impact of various asthma traits on outcomes in patients with asthma and COVID-19 infection,” the researchers write.

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