SARS-CoV-2 as a trigger of eosinophilic pneumonia

Araújo, Marhia Eduarda Vilela de; Correia, S; Lima, André Meyer Alves de; Costa, Maria Beatriz Tavares da; Neves, Isabel

doi:10.1016/j.pulmoe.2021.07.007

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…There have been small studies on rhinovirus and respiratory syncytial virus, showing slight elevation of the BAL eosinophil fraction due to infection [9,10]. However, except for a few case reports of in uenza (H1N1) and COVID-19 [11][12][13], there are no reports of cases of eosinophilic pneumonia diagnosed with signi cant BAL eosinophil fraction elevation due to respiratory virus infection.…”

Section: Discussionmentioning

confidence: 99%

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Nabeya

Setoguchi

Ueno

et al. 2023

Preprint

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Background:Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory viral infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital. Methods: Among the BAL procedures performed at our hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on the eosinophil fraction of BAL was analyzed using statistical analysis. A case study of respiratory virus detection in which the eosinophil fraction of BAL was elevated was also conducted. Results: A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a trend toward a higher eosinophil fraction in BAL fluid than the PCR-negative group (p=0.030), and more cases had a BAL eosinophil fraction >3% (p=0.017). Multivariate analysis showed that PCR-positive cases were associated with BAL eosinophil fractions >1% and >3%. There were nine PCR-positive cases with a BAL eosinophil fraction >1%, of which two cases with parainfluenza virus infection had a significantly elevated BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia. Conclusions: A trend toward an elevated eosinophil fraction in BAL fluid was observed in cases of viral infection of the lower respiratory tract. The degree of eosinophilic fraction elevation due to respiratory viral infection was mild overall, whereas some cases showed prominent elevation and were diagnosed with eosinophilic pneumonia. Respiratory viral infection is not a rare cause of elevated BAL eosinophilic fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.

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Section: Discussionmentioning

confidence: 99%

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Nabeya

Setoguchi

Ueno

et al. 2023

Preprint

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“…In these two patients, eosinophilic pneumonia was probably caused by parainfluenza infection since there was no other obvious cause. Although there have been reports of cases of eosinophilic pneumonia with a marked elevation of BAL eosinophil fraction in influenza virus infection and COVID-19 [24][25][26], there are no reports of eosinophilic pneumonia caused by parainfluenza virus. There has been a case report of parainfluenza virus pneumonia; however, the increase of BAL eosinophils was mild and not eosinophilic pneumonia [27].…”

Section: Discussionmentioning

confidence: 99%

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

et al. 2023

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Background Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory virus infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital. Methods Among the BAL procedures performed at the University of the Ryukyu Hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on BAL eosinophil fraction was analyzed using statistical analysis. A case study was conducted on respiratory virus detection, which showed an elevated BAL eosinophil fraction. Results A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a higher BAL eosinophil fraction than the PCR-negative group (p = 0.030), and more cases had a BAL eosinophil fraction > 3% (p = 0.017). Multivariate analysis revealed that being PCR-positive was significantly associated with BAL eosinophil fraction > 1% and > 3%. There were nine PCR-positive cases with a BAL eosinophil fraction > 1%, of which two cases with parainfluenza virus infection had a marked elevation of BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia. Conclusions Cases of viral infection of the lower respiratory tract showed an elevated BAL eosinophil fraction. The increase in eosinophil fraction due to respiratory virus infection was generally mild, whereas some cases showed marked elevation and were diagnosed with eosinophilic pneumonia. Respiratory virus infection is not a rare cause of elevated BAL eosinophil fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.

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“…Since AEP can be caused by infections, we cannot rule out the possibility that the SARS-CoV-2 infection also has this evolution. Three previous studies describe AEP after SARS-CoV-2 infection, raising the hypothesis that it is a predisposing factor for the development of the disease [3][4][5]. The usual treatment for AEP involves the administration of corticosteroids in high doses to alleviate inflammation and inhibit the immune system.…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Eosinophilic Pneumonia Triggered by the SARS-CoV-2 Virus

Monteiro¹,

Moura²,

Fernandes³

et al. 2023

Cureus

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We report a case of acute eosinophilic pneumonia (AEP) triggered by the coronavirus disease 2019 (COVID-19) infection. A 60-year-old male with chronic sinusitis and tobacco use presented to the emergency department (ED) with an acute onset of dyspnea, non-productive cough, and fever. A diagnosis of moderate SARS-CoV-2 infection with bacterial superinfection was made. He was discharged on antibiotic therapy. One month later, due to the persistence of symptoms, he returned to the ED. At this time, blood analysis showed eosinophilia and a chest computed tomography scan showed bilateral diffuse infiltrative changes. He was admitted to the hospital for the study of eosinophilic disease. A lung biopsy was performed, which showed eosinophilic pneumonia. Corticotherapy was started with symptoms and peripheral eosinophilia resolution, and imaging improvement.

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SARS-CoV-2 as a trigger of eosinophilic pneumonia

Cited by 7 publications

References 6 publications

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

A Case of Acute Eosinophilic Pneumonia Triggered by the SARS-CoV-2 Virus

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