Silent existence of eosinopenia in sepsis: a systematic review and meta-analysis

Abstract

Background Sepsis is a life-threatening and time-critical medical emergency; therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. However, its clinical application progress is slow and its recognition is low. Recent studies have again focused on the potential association between Eosinopenia and severe infections. This study analyzed the efficacy of Eosinopenia as a biomarker for diagnosis of sepsis and its correlation with pathophysiology of sepsis. Method The protocol for this meta-analysis is available in PROSPERO (CRD42020197664). We searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials CENTRAL databases to identify studies that met the inclusion criteria. Two authors performed data extraction independently. The pooled outcomes were calculated by TP (true positive), FP (false positive), FN (false negative), TN (true negative) by using bivariate meta-analysis model in STATA 14.0 software. Meanwhile, possible mechanisms of sepsis induced Eosinopenia was also analyzed. Results Seven studies were included in the present study with a total number of 3842 subjects. The incidence of Eosinopenia based on the enrolled studies varied from 23.2 to 92.7%. For diagnosis of sepsis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of Eosinopenia were 0.66 (95%CI [0.53–0.77]), 0.68 (95%CI [0.56–0.79]), 2.09 (95%CI [1.44–3.02]), 0.49 (95%CI [0.34–0.71]) and 4.23 (95%CI [2.15–8.31]), respectively. The area under the summary receiver operator characteristic curve (SROC) was 0.73 (95%CI [0.68–0.76]). Meta-regression analysis revealed that no single parameter accounted for the heterogeneity of pooled outcomes. For each subgroup of different eosinopenia cutoff values (50, 40, ≤25, 100), the sensitivity was 0.61, 0.79, 0.57, 0.54, and the specificity was 0.61, 0.75, 0.83, 0.51, respectively. Conclusions Our findings suggested that Eosinopenia has a high incidence in sepsis but has no superiority in comparison with conventional biomarkers for diagnosis of sepsis. However, eosinopenia can still be used in clinical diagnosis for sepsis as a simple, convenient, fast and inexpensive biomarker. Therefore, further large clinical trials are still needed to re-evaluate eosinopenia as a biomarker of sepsis.

Predictive role of blood eosinophils in adult varicella patients

“…In this study, all cases of deep abscesses and sepsis secondary to skin infections appeared in the eosinopenia group, which was consistent with previous research that demonstrated eosinophils may be a marker during bacterial infections [ 3 , 4 ]. Thus, we can make better diagnoses and reduce antibiotic abuse in adult varicella patients with eosinophils.…”

“…Eosinophils were considered as protective factors in respiratory viruses infections in recent studies [3][4][5][6]. It has been demonstrated that the eosinophil antiviral response depends on the inclusion and production of molecules with antiviral activity, including RNA enzymes and active nitrogen species, the participation of eosinophils in adaptive immunity because they can act as antigen-presenting cells, and the eosinophil extracellular traps [6].…”

The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis

“…A recent meta-analysis by Lin et al, including a total of 3.842 patients, showed that eosinopenia has a high incidence in sepsis, but it is not superior to conventional biomarkers for diagnosing sepsis, such as C reactive protein (CRP) and procalcitonin (PCT) [52]. It should be considered that the studies currently available on the accuracy of eosinopenia as a sepsis biomarker present a high heterogeneity, with sensitivity ranging from 23.2 to 92.5% and specificity from 28.57 to 91%.…”

Usefulness of serum C-reactive protein and calprotectin for the early detection of colorectal anastomotic leakage: A prospective observational study

“…Shaaban et al [ 37 ] defined an optimum cut-off value of 50 cells/μL, which produced an SS, SP, and NPV of 81%, 65% and 80%, respectively. At hospital admission, ECC < 40 cells/μL is an independent prognostic factor for mortality[ 38 , 39 ]. Our study is original in assessing the usefulness of ECC for the early diagnosis of CAL.…”

“…The usefulness of CRP as a biomarker for early detection of CAL has been investigated by several groups[ 19 , 25 , 39 , 41 , 42 ]. In this study, the plasma CRP level exhibited a propensity to normalize from POD3 onwards in patients without CAL (G1 and G2).…”