Eosinopenia could be a relevant prognostic biomarker in patients with coronavirus disease 2019

Perlini, Stefano; Ciprandi, Giorgio; Castagnoli, Riccardo

doi:10.2500/aap.2020.41.200079

Cited by 18 publications

(16 citation statements)

References 5 publications

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“…We observed severe eosinopenia and basopenia in our patients with SARS-CoV-2 pneumonia at hospital admission. Our results were in agreement with previous observations in COVID-19 patients requiring hospitalization in acute care settings of different intensity, i.e., from internal medicine wards to intensive care units [17][18][19][20]25]. Regarding eosinopenia, as a simple biological marker of SARS-CoV-2 infection, our results and those of a recent published study in hospitalized patients with pneumonia indicate the same cutoff of 10 eosinophils/mm 3 and the same sensitivity of 89% for COVID-19 diagnosis [29].…”

Section: Discussionsupporting

confidence: 93%

“…The diagnosis of CAP generally requires the demonstration of an infiltrate on the chest radiograph in a patient with a clinically compatible syndrome, i.e., fever, dyspnea, and cough. During the coronavirus disease 2019 (COVID- 19) pandemic, all patients with possible CAP are required to be tested for SARS-CoV-2, since CAP and COVID-19 pneumonia can show similar clinical presentations [2,3]. Early COVID-19 recognition is crucial for timely patient isolation to prevent the spread of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…Immune dysregulation plays a pivotal role in SARS-CoV-2 infection leading to a characteristic pattern of blood leukocytes [16]. Lymphocyte, monocyte, basophil, and eosinophil counts are reduced in proportion to the severity of the disease [17][18][19]. Severe lymphopenia is associate with delayed viral elimination and uncontrolled cytokine production, leading to influx of myeloid cells into the lungs [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Ruling Out Coronavirus Disease 2019 in Patients with Pneumonia: The Role of Blood Cell Count and Lung Ultrasound

Biolo

Fiotti

Cominotto

et al. 2021

JCM

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Coronavirus disease 2019 (COVID-19) is characterized by a distinctive blood leucocyte pattern and B-lines on lung ultrasound (LUS) as marker of alveolar-interstitial syndrome. We aimed to evaluate the accuracy of blood leucocyte count alone or in combination with LUS for COVID-19 diagnosis. We retrospectively enrolled consecutive patients diagnosed with community acquired pneumonia (CAP) at hospital admission to derive and validate cutoff values for blood cell count that could be predictive of COVID-19 before confirmation by the nucleic acid amplification test (NAAT). Cutoff values, generated and confirmed in inception (41/115, positive/negative patients) and validation (100/180, positive/negative patients) cohorts, were ≤17 and ≤10 cells/mm3 for basophils and eosinophils, respectively. Basophils and/or eosinophils below cutoff were associated with sensitivity of 98% (95%CI, 94–100) and negative likelihood ratio of 0.04 (95%CI, 0.01–0.11). In a subgroup of 265 subjects, the sensitivity of B-line on LUS was 15% lower (p < 0.001) than that of basophils and/or eosinophils below cutoff. The combination of B-lines with basophils and eosinophils below cutoff was associated with a moderate increase of the positive likelihood ratio: 5.0 (95%CI, 3.2–7.7). In conclusion, basophil and eosinophil counts above the generated cutoff virtually rule out COVID-19 in patients with CAP. Our findings can help optimize patient triage pending the NAAT results.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ruling Out Coronavirus Disease 2019 in Patients with Pneumonia: The Role of Blood Cell Count and Lung Ultrasound

Biolo

Fiotti

Cominotto

et al. 2021

JCM

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“…Eosinopenia is emerging as an early prognostic biomarker of severe COVID-19 in adults and children [15]. Our group demonstrated a significantly lower eosinophil count in children with COVID-19 than those with allergy and asthma [16].…”

Section: Introductionmentioning

confidence: 51%

What are the considerations for treating pediatric asthma during the COVID-19 pandemic?

Licari

2021

Expert Opinion on Pharmacotherapy

Self Cite

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“…Persistent eosinopenia has been directly correlated with severe COVID-19 with a positive predictive value of over 72% [186][187][188][189][190][191][192][193][194][195][196], and eosinophil counts on peripheral blood have been proposed as biomarkers [187,197]. Eosinophil counts appear to be very low, with a minimum at day 4 [197] when patients arrive to the hospital and the numbers slowly increase in those patients that recover, while continuing at minimum levels for those with severe manifestations of the disease [196].…”

Section: Eosinophils and Covid-19 Infectionmentioning

confidence: 99%

“NETs and EETs, a Whole Web of Mess”

et al. 2020

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Neutrophils and eosinophils are granulocytes that have very distinct functions. Neutrophils are first responders to external threats, and they use different mechanisms to control pathogens. Phagocytosis, reactive oxygen species, and neutrophil extracellular traps (NETs) are some of the mechanisms that neutrophils utilize to fight pathogens. Although there is some controversy as to whether NETs are in fact beneficial or detrimental to the host, it mainly depends on the biological context. NETs can contribute to disease pathogenesis in certain types of diseases, while they are also undeniably critical components of the innate immune response. On the contrary, the role of eosinophils during host immune responses remains to be better elucidated. Eosinophils play an important role during helminthic infections and allergic responses. Eosinophils can function as effector cells in viral respiratory infections, gut bacterial infections, and as modulators of immune responses by driving the balance between Th1 and Th2 responses. In particular, eosinophils have biological activities that appear to be quite similar to those of neutrophils. Both possess bactericidal activity, can activate proinflammatory responses, can modulate adaptive immune responses, can form extracellular traps, and can be beneficial or detrimental to the host according to the underlying pathology. In this review we compare these two cell types with a focus on highlighting their numerous similarities related to extracellular traps.

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Eosinopenia could be a relevant prognostic biomarker in patients with coronavirus disease 2019

Cited by 18 publications

References 5 publications

Ruling Out Coronavirus Disease 2019 in Patients with Pneumonia: The Role of Blood Cell Count and Lung Ultrasound

Ruling Out Coronavirus Disease 2019 in Patients with Pneumonia: The Role of Blood Cell Count and Lung Ultrasound

What are the considerations for treating pediatric asthma during the COVID-19 pandemic?

“NETs and EETs, a Whole Web of Mess”

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