Relationship between Low Eosinophil Level at Presentation and Disease Severity and Mortality in Covid-19 Patients

Elif Çelikel; Afşin Kayıpmaz

doi:10.31067/acusaglik.988531

Research Article

Year 2022, Volume: 13 Issue: 2, 220 - 224, 15.03.2022

Elif Çelikel , Afşin Kayıpmaz

https://doi.org/10.31067/acusaglik.988531

Abstract

References

1. Reference1: Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33. DOI: 10.1056/NEJMoa2001017
2. Reference 2: Demirbilek Y, Pehlivantürk G, Özgüler ZÖ ,et al. Covid-19 outbreak control, example of ministry of health of turkey. Turkish J Med Sci. 2020;50(SI-1):489–94. DOİ:10.3906/sag-2004-187
3. Reference 3: Huang C, Wang Y, Li X, et al. Articles Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;497–506. DOI:https://doi.org/10.1016/S0140-6736(20)30183-5
4. Reference 4: Zou L, Feng R, Mingxing H, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. New Engl J Med. 2020;1:1177–9. DOI: 10.1056/NEJMc2001737
5. Reference 5: Chan JF, Yuan S, Kok K, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission : a study of a family cluster. Lancet. 2020;395(10223):514–23. DOI:https://doi.org/10.1016/S0140-6736(20)30154-9
6. Reference 6: Bai Y, Yao L, Wei T, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. Journal of the American Medical Association. 2020;323 (14):1406-1407. DOI:10.1001/jama.2020.2565
7. Reference 7: Booth CM, Matukas LM, Tomlinson GA, et al.Clinical Features and Short-term Outcomes of 144 Patients with SARS in the Greater Toronto Area. J Am Med Assoc. 2003;289(21):2801–9. DOI: 10.1001/jama.289.21.JOC30885
8. Reference 8: Roncon L, Zuin M, Rigatelli G, et al.Diabetic patients with COVID-19 infection are at higher risk of ICU T admission and poor short-term outcome. J Clin Virol. 2020;127. DOI: 10.1016/j.jcv.2020.104354
9. Reference 9: Jang JG, Hur J, Choi EY, et al.Prognostic factors for severe coronavirus disease 2019 in Daegu, Korea. J Korean Med Sci. 2020;35(23):1–10. DOI: 10.3346/jkms.2020.35.e209
10. Reference 10: Patey C, Asghari S, Norman P, et al. Redesign of a rural emergency department to prepare for the COVID-19 pandemic. CMAJ. 2020. p. 192(19):518-520. DOI: https://doi.org/10.1503/cmaj.200509
11. Reference 11: Zhou Y, Zhang Z, Tian J, et al. Risk factors associated with disease progression in a cohort of patients infected with the 2019 novel coronavirus. 2020;9(2):428–36. DOI: 10.21037/apm.2020.03.26.
12. Reference 12: Lu G, Wang J. Dynamic changes in routine blood parameters of a severe COVID-19 case. Clin Chim Acta. 2020;508:98–102. DOI: 10.1016/j.cca.2020.04.034.
13. Reference 13: Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination. Journal of Allergy and Clinical Immunology. 2020;146 (1):1-7. DOI: 10.1016/j.jaci.2020.04.021
14. Reference 14: Flores-Torres AS, Salinas-Carmona MC, Salinas E, et al. Reviews Eosinophils and Respiratory Viruses. Viral İmmunology. 2019;32(5):198–207. DOI: 10.1089/vim.2018.0150.
15. Reference 15: Du Y, Tu L, Zhu P, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: A retrospective observational study. Am J Respir Crit Care Med. 2020;201(11):1372–9. DOI: 10.1164/rccm.202003-0543OC.
16. Reference 16: Sanderson CJ. Interleukin-5, eosinophils, and disease. Blood. 1992; 79 (12):3101-3109. https://doi.org/10.1182/blood.V79.12.3101.3101
17. Reference 17: Ukkonen M, Jämsen E, Zeitlin R, et al. Emergency department visits in older patients: A population-based survey. BMC Emerg Med. 2019;19:20 DOI: 10.1186/s12873-019-0236-3.
18. Reference 18: Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet. 2020;8:506–17. DOI: 10.1016/S2213-2600(20)30161-2.
19. Reference 19: Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13. DOI:https://doi.org/10.1016/S0140-6736(20)30211-7
20. Reference 20: Liu S, Zhi Y, Ying S. COVID-19 and Asthma: Reflection During the Pandemic. Clin Rev Allergy Immunol. 2020;59(1):78–88. DOI: 10.1007/s12016-020-08797-3
21. Reference 21: Sun S, Cai X, Wang H. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174–80. DOI: 10.1016/j.cca.2020.04.024
22. Reference 22: Hogan SP, Rosenberg HF, Moqbel R, et al.Eosinophils: Biological Properties and Role in Health and Disease Clinical and Experimental Allergy 2008;38:709–750 DOI: 10.1111/j.1365-2222.2008.02958.x
23. Reference 23: Drake MG, Bivins-Smith ER, Proskocil BJ, et al. Human and Mouse Eosinophils Have Antiviral Activity against Parainfluenza Virus. American Journal of Respiratory Cell and Molecular Biology.2016;55:(3);387-394
24. Reference 24: Sun DW , Zhang D, Tian RH, et al. The underlying changes and predicting role of peripheral blood inflammatory cells in severe COVID-19 patients: A sentinel? Clin Chim Acta. 2020;122–9.
25. Reference 25: Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324–9. DOI: 10.1111/jth.14859.
26. Reference 26: Xiang JZ, Cao DY, Yang YYY, et al. Clinical characteristics of 140 patients infected with SARS- CoV-2 in Wuhan, China. Eur J of allergy Clin Immunol. 2020;1–12. DOI: 10.1111/all.14238
27. Reference 27: Lippi G, Henry BM. Eosinophil count in severe coronavirus disease 2019. An İnternational J Med. 2020;113(7):511–2. https://doi.org/10.1093/qjmed/hcaa137
28. Reference 28: Ma J, Shi X, Xu W, et al. Development and validation of a risk stratification model for screening suspected cases of COVID-19 in China. Aging (Albany NY). 2020;323(14):1406–7. DOI: 10.18632/aging.103694
29. Reference 29: Lippi G, Henry BM. Eosinophil count in severe coronavirus disease 2019. An İnternational J Med. 2020;113(7):511–2. https://doi.org/10.1093/qjmed/hcaa137

Relationship between Low Eosinophil Level at Presentation and Disease Severity and Mortality in Covid-19 Patients

Year 2022, Volume: 13 Issue: 2, 220 - 224, 15.03.2022

Elif Çelikel , Afşin Kayıpmaz

https://doi.org/10.31067/acusaglik.988531

Abstract

Amaç
Covid-19 tanısının erken ve hızlı tespit edilmesi mortaliteyi azaltmak için önemlidir. Eozinofil düzeyinin Covid-19 şüpheli vakalarda ilk başvuru anında düşük tespit edilmesinin hastalığın tanısını koymada ve ciddiyetini öngörebilmede kullanılabileceği belirtilmiştir. Çalışmamızda vakalarımızın eozinofil düzeyine bakarak bu parametrenin Covid-19 erken tanı ve tedavi planlanmasında kullanılabilirliğini saptamayı amaçladık.
Gereç ve Yöntem
Retrospektif olarak yapılan bu çalışmaya Covid-19 ön tanısı ile yatan vakaları aldık .Hastaların demografik özellikleri, laboratuar değerleri, radyolojik görüntüleri ve klinik takip bilgileri hastane bilgisayar sisteminden tarandı. SPSS 25 programı ile istatistik hesapları yapıldı.
Bulgular
Hastalarımızın 37’si kadındır (%30,08). Yaş ortalaması 49,13 ve en çok vakayı 26-65 yaş aralığında tespit ettik. En sık semptom olarak öksürük %51,21, dispne %26,8 ve ateş %26,39 görüldü. En sık görülen komorbid hastalık hipertansiyon %21,95 ve diyabet %12,19. Vakalarımızın %50,40’ın da (n:62) bilgisayarlı tomografisin de viral pnömoni (konsolüdasyon, buzlu cam opasiteleri), %49,59’unda (n:61) Polimeraz Zincir Reaksiyonu pozitifliği ve %39,02’sin de (n:48) ise hem bilgisayarlı tomografi’de viral pnömoni hem de PCR (+) tespit edildi. Vefat eden vakalarımızda ilk başvuruda eozinofil düzeylerinde düşüklüğü tespit ettik.
Sonuç
Eozinofil düzeyi düşüklüğü covid-19 şüpheli vakalarda tanıyı destekleyebilir ve klinik tablonun ciddi seyredebileceği ile ilgili bir uyarı olabilir.

Anahtar kelime: Covid-19, Eozinopeni, Mortalite

Abstract
Purpose
Early and rapid diagnosis of COVID -19 is vital to reduce mortality. It has been shown that detecting low eosinophil levels at the first application in suspected cases of COVID -19 can be used to diagnose the disease and predict its severity. In the present study, we aimed to determine the usability of this parameter in the early diagnosis of COVID-19 and treatment planning by evaluating at the eosinophil levels.
Methods
As a retrospective study included those who were admitted to the hospital, with the pre-diagnosis of COVID-19. Demographic characteristics, laboratory values, radiological images and clinical follow-up were scanned through the hospital system. All statistical analysis was done using the SPSS v25 software.
Result
Thirty-seven women (30.08%) were included in our study. The average age was 49.13, and we found the most cases in the 26-65 age range. The most common symptoms were cough 51.21%, dyspnea 26.8% and fever 26.39%. Hypertension was detected 21.95% and diabetes 12.19% as comorbid diseases. A computed tomography scan showed viral pneumonia in 50.40% (n:62) of our cases. 49.59% (n: 61) had Polymerase chain reaction positive results and 39.02% (n: 48) of our cases had both viral pneumonia in the CT scan and PCR (+). We found that dead patients had significant lower eosinophil levels.
Conclusion
eosinophil level may support the diagnosis in suspected cases of covid-19 and maybe a warning that the clinical picture may progress seriously.

Keywords

Covid-19, Eosinopenia, Severity

References

1. Reference1: Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–33. DOI: 10.1056/NEJMoa2001017
2. Reference 2: Demirbilek Y, Pehlivantürk G, Özgüler ZÖ ,et al. Covid-19 outbreak control, example of ministry of health of turkey. Turkish J Med Sci. 2020;50(SI-1):489–94. DOİ:10.3906/sag-2004-187
3. Reference 3: Huang C, Wang Y, Li X, et al. Articles Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;497–506. DOI:https://doi.org/10.1016/S0140-6736(20)30183-5
4. Reference 4: Zou L, Feng R, Mingxing H, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. New Engl J Med. 2020;1:1177–9. DOI: 10.1056/NEJMc2001737
5. Reference 5: Chan JF, Yuan S, Kok K, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission : a study of a family cluster. Lancet. 2020;395(10223):514–23. DOI:https://doi.org/10.1016/S0140-6736(20)30154-9
6. Reference 6: Bai Y, Yao L, Wei T, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. Journal of the American Medical Association. 2020;323 (14):1406-1407. DOI:10.1001/jama.2020.2565
7. Reference 7: Booth CM, Matukas LM, Tomlinson GA, et al.Clinical Features and Short-term Outcomes of 144 Patients with SARS in the Greater Toronto Area. J Am Med Assoc. 2003;289(21):2801–9. DOI: 10.1001/jama.289.21.JOC30885
8. Reference 8: Roncon L, Zuin M, Rigatelli G, et al.Diabetic patients with COVID-19 infection are at higher risk of ICU T admission and poor short-term outcome. J Clin Virol. 2020;127. DOI: 10.1016/j.jcv.2020.104354
9. Reference 9: Jang JG, Hur J, Choi EY, et al.Prognostic factors for severe coronavirus disease 2019 in Daegu, Korea. J Korean Med Sci. 2020;35(23):1–10. DOI: 10.3346/jkms.2020.35.e209
10. Reference 10: Patey C, Asghari S, Norman P, et al. Redesign of a rural emergency department to prepare for the COVID-19 pandemic. CMAJ. 2020. p. 192(19):518-520. DOI: https://doi.org/10.1503/cmaj.200509
11. Reference 11: Zhou Y, Zhang Z, Tian J, et al. Risk factors associated with disease progression in a cohort of patients infected with the 2019 novel coronavirus. 2020;9(2):428–36. DOI: 10.21037/apm.2020.03.26.
12. Reference 12: Lu G, Wang J. Dynamic changes in routine blood parameters of a severe COVID-19 case. Clin Chim Acta. 2020;508:98–102. DOI: 10.1016/j.cca.2020.04.034.
13. Reference 13: Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination. Journal of Allergy and Clinical Immunology. 2020;146 (1):1-7. DOI: 10.1016/j.jaci.2020.04.021
14. Reference 14: Flores-Torres AS, Salinas-Carmona MC, Salinas E, et al. Reviews Eosinophils and Respiratory Viruses. Viral İmmunology. 2019;32(5):198–207. DOI: 10.1089/vim.2018.0150.
15. Reference 15: Du Y, Tu L, Zhu P, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: A retrospective observational study. Am J Respir Crit Care Med. 2020;201(11):1372–9. DOI: 10.1164/rccm.202003-0543OC.
16. Reference 16: Sanderson CJ. Interleukin-5, eosinophils, and disease. Blood. 1992; 79 (12):3101-3109. https://doi.org/10.1182/blood.V79.12.3101.3101
17. Reference 17: Ukkonen M, Jämsen E, Zeitlin R, et al. Emergency department visits in older patients: A population-based survey. BMC Emerg Med. 2019;19:20 DOI: 10.1186/s12873-019-0236-3.
18. Reference 18: Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet. 2020;8:506–17. DOI: 10.1016/S2213-2600(20)30161-2.
19. Reference 19: Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13. DOI:https://doi.org/10.1016/S0140-6736(20)30211-7
20. Reference 20: Liu S, Zhi Y, Ying S. COVID-19 and Asthma: Reflection During the Pandemic. Clin Rev Allergy Immunol. 2020;59(1):78–88. DOI: 10.1007/s12016-020-08797-3
21. Reference 21: Sun S, Cai X, Wang H. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174–80. DOI: 10.1016/j.cca.2020.04.024
22. Reference 22: Hogan SP, Rosenberg HF, Moqbel R, et al.Eosinophils: Biological Properties and Role in Health and Disease Clinical and Experimental Allergy 2008;38:709–750 DOI: 10.1111/j.1365-2222.2008.02958.x
23. Reference 23: Drake MG, Bivins-Smith ER, Proskocil BJ, et al. Human and Mouse Eosinophils Have Antiviral Activity against Parainfluenza Virus. American Journal of Respiratory Cell and Molecular Biology.2016;55:(3);387-394
24. Reference 24: Sun DW , Zhang D, Tian RH, et al. The underlying changes and predicting role of peripheral blood inflammatory cells in severe COVID-19 patients: A sentinel? Clin Chim Acta. 2020;122–9.
25. Reference 25: Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324–9. DOI: 10.1111/jth.14859.
26. Reference 26: Xiang JZ, Cao DY, Yang YYY, et al. Clinical characteristics of 140 patients infected with SARS- CoV-2 in Wuhan, China. Eur J of allergy Clin Immunol. 2020;1–12. DOI: 10.1111/all.14238
27. Reference 27: Lippi G, Henry BM. Eosinophil count in severe coronavirus disease 2019. An İnternational J Med. 2020;113(7):511–2. https://doi.org/10.1093/qjmed/hcaa137
28. Reference 28: Ma J, Shi X, Xu W, et al. Development and validation of a risk stratification model for screening suspected cases of COVID-19 in China. Aging (Albany NY). 2020;323(14):1406–7. DOI: 10.18632/aging.103694
29. Reference 29: Lippi G, Henry BM. Eosinophil count in severe coronavirus disease 2019. An İnternational J Med. 2020;113(7):511–2. https://doi.org/10.1093/qjmed/hcaa137

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Details

Primary Language	English
Subjects	Emergency Medicine
Journal Section	Research Articles
Authors	Elif Çelikel 0000-0001-5597-7757 Afşin Kayıpmaz 0000-0002-3578-4015
Publication Date	March 15, 2022
Submission Date	August 30, 2021
Published in Issue	Year 2022Volume: 13 Issue: 2

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EndNote	Çelikel E, Kayıpmaz A (March 1, 2022) Relationship between Low Eosinophil Level at Presentation and Disease Severity and Mortality in Covid-19 Patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13 2 220–224.

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