Tuberc Respir Dis.  2024 Oct;87(4):465-472. 10.4046/trd.2023.0174.

Eosinophilia Is a Favorable Marker for Pneumonia in Chronic Obstructive Pulmonary Disease

• Gu KM
• Jung JW
• Kang MJ
• Kim DK
• Choi H
• Cho YJ
• Jang SH
• Lee CH
• Oh YM
• Park JS
• Kim JY

• KMID: 2559330
• DOI: http://doi.org/10.4046/trd.2023.0174

Abstract

Background
Patients with chronic obstructive pulmonary disease (COPD) expressing eosinophilia experience slightly fewer episodes of community-acquired pneumonia (CAP), than those without eosinophilia. However, the severity and burden of hospitalized pneumonia patients with COPD involving eosinophilia have not been assessed.
Methods
We evaluated the differences in clinical characteristics between patients with CAP and COPD with or without eosinophilia by a post hoc analysis of a prospective, multi-center, cohort study data.
Results
Of 349 CAP patients with COPD, 45 (12.9%) had eosinophilia (blood eosinophil ≥300 cells/μL). Patients with eosinophilia had a lower sputum culture percentile (8.1% vs. 23.4%, p<0.05), a lower percentile of neutrophils (70.3% vs. 80.2%, p<0.05), reduced C-reactive protein levels (30.6 mg/L vs. 86.6 mg/L, p<0.05), and a lower pneumonia severity index score (82.5 vs. 90.0, p<0.05), than those without eosinophilia. The duration of antibiotic treatment (8.0 days vs. 10.0 days, p<0.05) and hospitalization (7.0 days vs. 9.0 days, p<0.05) were shorter in eosinophilic patients. The cost of medical care per day (256.4 US$ vs. 291.0 US$, p<0.05), cost for the medication (276.4 US$ vs. 349.9 US$, p<0.05), and cost for examination (685.5 US$ vs. 958.1 US$, p<0.05) were lower in patients with eosinophilia than those without eosinophilia.
Conclusion
Eosinophilia serves as a favorable marker for the severity of pneumonia, health-care consumption, and cost of medical care in patients with CAP and COPD.

Keyword

Chronic Obstructive Pulmonary Disease; Pneumonia; Eosinophilia; Severity; Cost