Eosinopenia as an Adverse Marker of Clinical Outcomes in Patients Presenting with Acute Myocardial Infarction

Alkhalil, Mohammad; Kearney, Aileen; Hegarty, Mairead; Stewart, Catherine; Devlin, Peadar; Owens, Colum; Spence, Mark S.

doi:10.1016/j.amjmed.2019.05.021

Cited by 26 publications

(24 citation statements)

References 25 publications

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“…Standard biochemical parameters, such as creatinine, Creactive protein (CRP), total leukocytes and lymphocytes, were also collected. Concerning circulating eosinophils, their normal rate stands between 100 and 400/mm 3 , eosinopenia is considered profound when the rate is inferior to 50/mm 3 and undetectable when it equals 0/mm 3 [7][8][9][10][11][12].…”

Section: Data Collectionmentioning

confidence: 99%

“…Numerous recent studies have described changes in white blood cell counts of patients with COVID-19, including a significant decrease in eosinophils and circulating lymphocytes [2][3][4][5][6]. The diagnostic and prognostic performance of blood eosinophils has been observed in different pathologies; this is mainly demonstrated in deep eosinopenia, with an eosinophil count below 50 to 10 per mm 3 [7][8][9][10][11][12]. The prognostic value of eosinopenia is described in bacterial infections presented by critically ill patients [7][8][9][10], and in non-infectious diseases such as myocardial infarction [11] and stroke [12]; thus far, eosinopenia appears to be a marker of increased mortality.…”

Section: Introductionmentioning

confidence: 99%

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Do Blood Eosinophils Predict in-Hospital Mortality or Severity of Disease in SARS-CoV-2 Infection? A Retrospective Multicenter Study

et al. 2021

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Introduction: Healthcare systems worldwide have been battling the ongoing COVID-19 pandemic. Eosinophils are multifunctional leukocytes implicated in the pathogenesis of several inflammatory processes including viral infections. We focus our study on the prognostic value of eosinopenia as a marker of disease severity and mortality in COVID-19 patients. Methods: Between 1 March and 30 April 2020, we conducted a multicenter and retrospective study on a cohort of COVID-19 patients (moderate or severe disease) who were hospitalized after presenting to the emergency department (ED). We led our study in six major hospitals of northeast France, one of the outbreak’s epicenters in Europe. Results: We have collected data from 1035 patients, with a confirmed diagnosis of COVID-19. More than three quarters of them (76.2%) presented a moderate form of the disease, while the remaining quarter (23.8%) presented a severe form requiring admission to the intensive care unit (ICU). Mean circulating eosinophils rate, at admission, varied according to disease severity (p < 0.001), yet it did not differ between survivors and non-survivors (p = 0.306). Extreme eosinopenia (=0/mm3) was predictive of severity (aOR = 1.77, p = 0.009); however, it was not predictive of mortality (aOR = 0.892, p = 0.696). The areas under the Receiver operating characteristics (ROC) curve were, respectively, 58.5% (CI95%: 55.3–61.7%) and 51.4% (CI95%: 46.8–56.1%) for the ability of circulating eosinophil rates to predict disease severity and mortality. Conclusion: Eosinopenia is very common and often profound in cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Eosinopenia was not a useful predictor of mortality; however, undetectable eosinophils (=0/mm3) were predictive of disease severity during the initial ED management.

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Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Do Blood Eosinophils Predict in-Hospital Mortality or Severity of Disease in SARS-CoV-2 Infection? A Retrospective Multicenter Study

et al. 2021

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“…Low eosinophil counts is often related to the use of glucosteroids [39]. Eosinopenia is also considered as a surrogate of inflammation in bacterial infections [40] or myocardial infarction [41]. Basophil counts could be reduced by chronic urticaria or with steroids [42].…”

Section: Plos Onementioning

confidence: 99%

Pre-test probability for SARS-Cov-2-related infection score: The PARIS score

et al. 2020

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Introduction In numerous countries, large population testing is impossible due to the limited availability of RT-PCR kits and CT-scans. This study aimed to determine a pre-test probability score for SARS-CoV-2 infection. Methods This multicenter retrospective study (4 University Hospitals) included patients with clinical suspicion of SARS-CoV-2 infection. Demographic characteristics, clinical symptoms, and results of blood tests (complete white blood cell count, serum electrolytes and CRP) were collected. A pre-test probability score was derived from univariate analyses of clinical and biological variables between patients and controls, followed by multivariate binary logistic analysis to determine the independent variables associated with SARS-CoV-2 infection. Results 605 patients were included between March 10th and April 30th, 2020 (200 patients for the training cohort, 405 consecutive patients for the validation cohort). In the multivariate analysis, lymphocyte (<1.3 G/L), eosinophil (<0.06 G/L), basophil (<0.04 G/L) and neutrophil counts (<5 G/L) were associated with high probability of SARS-CoV-2 infection but no clinical variable was statistically significant. The score had a good performance in the validation cohort (AUC = 0.918 (CI: [0.891–0.946]; STD = 0.014) with a Positive Predictive Value of high-probability score of 93% (95%CI: [0.89–0.96]). Furthermore, a low-probability score excluded SARS-CoV-2 infection with a Negative Predictive Value of 98% (95%CI: [0.93–0.99]). The performance of the score was stable even during the last period of the study (15-30th April) with more controls than infected patients. Conclusions The PARIS score has a good performance to categorize the pre-test probability of SARS-CoV-2 infection based on complete white blood cell count. It could help clinicians adapt testing and for rapid triage of patients before test results.

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“…Certain blood biomarkers have been established to reflect the systemic inflammatory state of an individual. [ 51 52 ] PVAT, on the other hand, is associated with local inflammation and may help to tailor medical therapy and/or invasive revascularization in future.…”

Section: The Role Of Other High-risk Atherosclerotic Plaque Features mentioning

confidence: 99%

A promising tool to tackle the risk of cerebral vascular disease, the emergence of novel carotid wall imaging

Alkhalil

2020

Brain Circ

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Stroke is a heterogeneous vascular disease. Carotid artery atherosclerosis is associated with almost one-quarter of ischemic strokes. Moreover, a large percentage of preventable strokes are currently attributed to carotid atherosclerosis. Over the past three decades, the management of carotid artery disease has evolved. The benefits of carotid revascularization alongside medical therapy have early been recognized. Nonetheless, the debate regarding the optimal strategy is still ongoing, particularly in patients with asymptomatic carotid artery disease. One of the challenges is the use of luminal stenosis to quantify the severity of the carotid artery disease and to guide decision-making regarding invasive revascularization. Characterizing carotid atherosclerotic plaque is a promising tool to identify vulnerable plaque. Certain features such as large lipid core have already been linked to acute vascular events, not only at the plaque level but also to predict systemic cardiovascular events. Recently, a quantitative T2 mapping magnetic resonance imaging technique was developed and validated against histology. The ability to accurately quantify plaque lipid content using this technique opens several new opportunities. In this review articles, we will discuss the current challenges in the management of carotid artery disease and the future roles of T2 mapping to aid therapeutic options. These roles may include how to determine the mode of invasive carotid revascularization in symptomatic patients. Moreover, there may be a rational to use T2 mapping as a risk stratification tool in asymptomatic patients with carotid artery stenosis. It may also provide an opportunity to stage atherosclerosis and identify patients with coronary atherosclerosis who may benefit maximally from intensive lipid interventions.

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Eosinopenia as an Adverse Marker of Clinical Outcomes in Patients Presenting with Acute Myocardial Infarction

Cited by 26 publications

References 25 publications

Do Blood Eosinophils Predict in-Hospital Mortality or Severity of Disease in SARS-CoV-2 Infection? A Retrospective Multicenter Study

Do Blood Eosinophils Predict in-Hospital Mortality or Severity of Disease in SARS-CoV-2 Infection? A Retrospective Multicenter Study

Pre-test probability for SARS-Cov-2-related infection score: The PARIS score

A promising tool to tackle the risk of cerebral vascular disease, the emergence of novel carotid wall imaging

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