The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort Study on Patients Hospitalised in Spanish Hospitals

{ 'institution': [{'name': 'medRxiv'}], 'indexed': {'date-parts': [[2022, 3, 30]], 'date-time': '2022-03-30T18:39:15Z', 'timestamp': 1648665555705}, 'posted': {'date-parts': [[2020, 8, 21]]}, 'group-title': 'Infectious Diseases (except HIV/AIDS)', 'reference-count': 25, 'publisher': 'Cold Spring Harbor Laboratory', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2020, 8, 21]]}, 'abstract': '<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>A ' 'decrease in blood cell counts, especially lymphocytes and eosinophils, has been described in ' 'patients with severe SARS-CoV-2 (COVID-19), but there is no knowledge of the potential role ' 'of their recovery in these patients’ prognosis. This article aims to analyse the effect of ' 'blood cell depletion and blood cell recovery on mortality due to ' 'COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>This work is a ' 'multicentre, retrospective, cohort study of 9,644 hospitalised patients with confirmed ' 'COVID-19 from the Spanish Society of Internal Medicine’s SEMI-COVID-19 ' 'Registry.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>This study ' 'examined patients hospitalised in 147 hospitals throughout ' 'Spain.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>This work ' 'analysed 9,644 patients (57.12% male) out of a cohort of 12,826 patients ≥18 years of age ' 'hospitalised with COVID-19 in Spain included in the SEMI-COVID-19 Registry as of 29 May ' '2020.</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>The ' 'main outcome measure of this work is the effect of blood cell depletion and blood cell ' 'recovery on mortality due to COVID-19. Univariate analysis was performed to determine ' 'possible predictors of death and then multivariate analysis was carried out to control for ' 'potential ' 'confounders.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>An increase ' 'in the eosinophil count on the seventh day of hospitalisation was associated with a better ' 'prognosis, including lower mortality rates (5.2% vs 22.6% in non-recoverers, OR 0.234 [95% ' 'CI, 0.154 to 0.354]) and lower complication rates, especially regarding to development of ' 'acute respiratory distress syndrome (8% vs 20.1%, p=0.000) and ICU admission (5.4% vs 10.8%, ' 'p=0.000). Lymphocyte recovery was found to have no effect on prognosis. Treatment with ' 'inhaled or systemic glucocorticoids was not found to be a confounding ' 'factor.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Eosinophil ' 'recovery in patients with COVID-19 is a reliable marker of a good prognosis that is ' 'independent of prior treatment. This finding could be used to guide discharge ' 'decisions.</jats:p></jats:sec>', 'DOI': '10.1101/2020.08.18.20172874', 'type': 'posted-content', 'created': {'date-parts': [[2020, 8, 22]], 'date-time': '2020-08-22T07:50:10Z', 'timestamp': 1598082610000}, 'source': 'Crossref', 'is-referenced-by-count': 2, 'title': 'The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort ' 'Study on Patients Hospitalised in Spanish Hospitals', 'prefix': '10.1101', 'author': [ {'given': 'María Mateos', 'family': 'González', 'sequence': 'first', 'affiliation': []}, {'given': 'Elena Sierra', 'family': 'Gonzalo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Irene Casado', 'family': 'Lopez', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Francisco Arnalich', 'family': 'Fernández', 'sequence': 'additional', 'affiliation': []}, {'given': 'José Luis Beato', 'family': 'Pérez', 'sequence': 'additional', 'affiliation': []}, {'given': 'Daniel Monge', 'family': 'Monge', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Juan Antonio Vargas', 'family': 'Núñez', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rosa García', 'family': 'Fenoll', 'sequence': 'additional', 'affiliation': []}, {'given': 'Carmen Suárez', 'family': 'Fernández', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Santiago Jesús Freire', 'family': 'Castro', 'sequence': 'additional', 'affiliation': []}, {'given': 'Manuel Mendez', 'family': 'Bailon', 'sequence': 'additional', 'affiliation': []}, {'given': 'Isabel Perales', 'family': 'Fraile', 'sequence': 'additional', 'affiliation': []}, {'given': 'Manuel', 'family': 'Madrazo', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Paula Maria Pesqueira', 'family': 'Fontan', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Jeffrey Oskar Magallanes', 'family': 'Gamboa', 'sequence': 'additional', 'affiliation': []}, {'given': 'Andrés González', 'family': 'García', 'sequence': 'additional', 'affiliation': []}, {'given': 'Anxela Crestelo', 'family': 'Vieitez', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Eva María Fonseca', 'family': 'Aizpuru', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Asier Aranguren', 'family': 'Arostegui', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ainara Coduras', 'family': 'Erdozain', 'sequence': 'additional', 'affiliation': []}, {'given': 'Carmen Martinez', 'family': 'Cilleros', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jose Loureiro', 'family': 'Amigo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Francisco', 'family': 'Epelde', 'sequence': 'additional', 'affiliation': []}, {'given': 'Carlos Lumbreras', 'family': 'Bermejo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Juan Miguel Antón', 'family': 'Santos', 'sequence': 'additional', 'affiliation': []}, {'name': 'for the SEMI-COVID-19 Network', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2021020112353787000_2020.08.18.20172874v1.1', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2001017'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.2', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.25678'}, { 'issue': '1', 'key': '2021020112353787000_2020.08.18.20172874v1.3', 'first-page': '157', 'article-title': 'WHO declares COVID-19 a pandemic', 'volume': '91', 'year': '2020', 'journal-title': 'Acta Biomed'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.4', 'unstructured': 'World Health Organization. Coronavirus disease (COVID-19) Situation ' 'Report - 155 [Internet]. 2020. Available from: ' 'https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.5', 'doi-asserted-by': 'crossref', 'unstructured': 'Ciotti M , Angeletti S , Minieri M , Giovannetti M , Benvenuto D , ' 'Pascarella S , et al. COVID-19 Outbreak: An Overview. Chemotherapy. ' '2020;', 'DOI': '10.1159/000507423'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.6', 'doi-asserted-by': 'crossref', 'unstructured': 'Wu Z , McGoogan JM . Characteristics of and Important Lessons from the ' 'Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a ' 'Report of 72314 Cases from the Chinese Center for Disease Control and ' 'Prevention. JAMA - J Am Med Assoc [Internet]. 2020; Available from: ' 'https://jamanetwork.com/', 'DOI': '10.1001/jama.2020.2648'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.7', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S0140-6736(20)30183-5'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.8', 'doi-asserted-by': 'crossref', 'unstructured': 'Zhou F , Yu T , Du R , Fan G , Liu Y , Liu Z , et al. Clinical course ' 'and risk factors for mortality of adult inpatients with COVID-19 in ' 'Wuhan, China: a retrospective cohort study. Lancet. 2020;', 'DOI': '10.1016/S0140-6736(20)30566-3'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.9', 'doi-asserted-by': 'crossref', 'unstructured': 'Chen T , Wu D , Chen H , Yan W , Yang D , Chen G , et al. Clinical ' 'characteristics of 113 deceased patients with coronavirus disease 2019: ' 'Retrospective study. BMJ. 2020 Mar 26;368.', 'DOI': '10.1136/bmj.m1091'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.10', 'doi-asserted-by': 'crossref', 'unstructured': 'Zheng Z , Peng F , Xu B , Zhao J , Liu H , Peng J , et al. Risk factors ' 'of critical & mortal COVID-19 cases: A systematic literature review and ' 'meta-analysis. Journal of Infection. W.B. Saunders Ltd; 2020.', 'DOI': '10.1016/j.jinf.2020.04.021'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.11', 'first-page': '11', 'volume-title': 'International Journal of Laboratory Hematology', 'volume': '42', 'year': '2020'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.12', 'doi-asserted-by': 'crossref', 'unstructured': 'Lindsley AW , Schwartz JT , Rothenberg ME . Eosinophil responses during ' 'COVID-19 infections and coronavirus vaccination. Journal of Allergy and ' 'Clinical Immunology. Mosby Inc.; 2020.', 'DOI': '10.1016/j.jaci.2020.04.021'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.13', 'doi-asserted-by': 'crossref', 'unstructured': 'Liu F , Xu A , Zhang Y , Xuan W , Yan T , Pan K , et al. Patients of ' 'COVID-19 may benefit from sustained lopinavir-combined regimen and the ' 'increase of eosinophil may predict the outcome of COVID-19 progression. ' 'Int J Infect Dis. 2020 Mar;', 'DOI': '10.1016/j.ijid.2020.03.013'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.14', 'doi-asserted-by': 'crossref', 'first-page': '174', 'DOI': '10.1016/j.cca.2020.04.024', 'article-title': 'Abnormalities of peripheral blood system in patients with COVID-19 in ' 'Wenzhou, China', 'volume': '507', 'year': '2020', 'journal-title': 'Clin Chim Acta'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.15', 'doi-asserted-by': 'crossref', 'unstructured': 'Lippi G , Henry BM . Eosinophil count in severe coronavirus disease 2019 ' '(COVID-19). QJM [Internet]. 2020; Available from: ' 'https://academic.oup.com/qjmed/article-abstract/doi/10.1093/qjmed/hcaa137/5823309', 'DOI': '10.1093/qjmed/hcaa137'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.16', 'doi-asserted-by': 'crossref', 'unstructured': 'J M Casas-Rojo , J M Antón-Santos , J. Millán-Núñez-Cortés , C. ' 'Lumbreras-Bermejo , J M Ramos-Rincón , E. Roy-Vallejo , et al. Clinical ' 'characteristics of patients hospitalized with COVID-19 in Spain: results ' 'from the SEMI-COVID-19 Registry. Revista Clínica Española. ' 'https://doi.org/10.1016/j.rce.2020.07.003', 'DOI': '10.1016/j.rce.2020.07.003'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.17', 'first-page': '1281', 'volume-title': 'American Journal of Respiratory and Critical Care Medicine', 'volume': '195', 'year': '2017'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.18', 'doi-asserted-by': 'crossref', 'unstructured': 'Halpin DMG , Faner R , Sibila O , Badia JR , Agusti A . Do chronic ' 'respiratory diseases or their treatment affect the risk of SARS-CoV-2 ' 'infection? Lancet Respir Med. 2020 Apr;', 'DOI': '10.1016/S2213-2600(20)30167-3'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.19', 'first-page': '214', 'volume-title': 'Clinical Reviews in Allergy and Immunology', 'volume': '50', 'year': '2015'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.20', 'doi-asserted-by': 'crossref', 'unstructured': 'Liu S , Zhi Y , Ying S . COVID-19 and Asthma: Reflection During the ' 'Pandemic. Clinical Reviews in Allergy and Immunology. Springer; 2020.', 'DOI': '10.1007/s12016-020-08797-3'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.21', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.diabres.2014.04.006'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.22', 'doi-asserted-by': 'crossref', 'unstructured': 'de Ruiter K , Tahapary DL , Sartono E , Soewondo P , Supali T , Smit JWA ' ', et al. Helminths, hygiene hypothesis and type 2 diabetes. Vol. 39, ' 'Parasite Immunology. Blackwell Publishing Ltd; 2017.', 'DOI': '10.1111/pim.12404'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.23', 'doi-asserted-by': 'crossref', 'unstructured': 'Zhang J , Wang X , Jia X , Li J , Hu K , Chen G , et al. Risk factors ' 'for disease severity, unimprovement, and mortality in COVID-19 patients ' 'in Wuhan, China. Clin Microbiol Infect. 2020;', 'DOI': '10.1016/j.cmi.2020.04.012'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.24', 'unstructured': 'Qin C , Zhou L , Hu Z , Zhang S , Yang S , Tao Y , et al. Dysregulation ' 'of immune response in patients with COVID-19 in Wuhan, China.'}, { 'key': '2021020112353787000_2020.08.18.20172874v1.25', 'doi-asserted-by': 'crossref', 'unstructured': 'Ackermann M , Verleden SE , Kuehnel M , Haverich A , Welte T , Laenger F ' ', et al. Pulmonary Vascular Endothelialitis, Thrombosis, and ' 'Angiogenesis in Covid-19. N Engl J Med [Internet]. 2020 May 21; ' 'Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2015432', 'DOI': '10.1056/NEJMoa2015432'}], 'container-title': [], 'original-title': [], 'link': [ { 'URL': 'https://syndication.highwire.org/content/doi/10.1101/2020.08.18.20172874', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 2, 2]], 'date-time': '2021-02-02T06:54:25Z', 'timestamp': 1612248865000}, 'score': 1, 'resource': {'primary': {'URL': 'http://medrxiv.org/lookup/doi/10.1101/2020.08.18.20172874'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 8, 21]]}, 'references-count': 25, 'URL': 'http://dx.doi.org/10.1101/2020.08.18.20172874', 'relation': {}, 'published': {'date-parts': [[2020, 8, 21]]}, 'subtype': 'preprint'}