Eosinophilia is a favorable marker for pneumonia in chronic obstructive pulmonary disease

Gu, Kang-Mo; Jung, Jae-Woo; Kang, Min-Jong; Kim, Deog Kyeom; Choi, Hayoung; Cho, Young-Jae; Jang, Seung Hun; Lee, Chang-Hoon; Oh, Yeon Mok; Park, Ji Sook; Kim, Jae Yeol

doi:.0..

Tuberc Respir Dis > Accepted Articles

Original Article

DOI: https://doi.org/10.4046/trd.2023.0174 [Accepted]
Published online May 3, 2024.

Eosinophilia is a favorable marker for pneumonia in chronic obstructive pulmonary disease

Kang-Mo Gu¹

¹Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
²Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America, 06520-8057
³Department of Internal Medicine, Seoul National University College of Medicine, SMG-SNU Borame Medical Center, Seoul, Republic of Korea
⁴Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
⁵Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
⁶Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
⁷Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
⁸Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
⁹Department of Software Convergence, Seoul Women's University College of Interdisciplinary Studies for Emerging Industries, Seoul, Republic of Korea

Correspondence: Jae Yeol Kim, Tel: +82-01-3173-7839, Fax: +82-2-825-7571,
Email: jykimmd@cau.ac.kr

Received: 27 October 2023 • Revised: 10 January 2024 • Accepted: 29 April 2024

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 concerning 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 severity of pneumonia, health-care consumption, and cost of medical care in patients with CAP and COPD.

Key Words: COPD, pneumonia, eosinophilia, severity, cost

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ORCID iDs

Kang-Mo Gu
https://orcid.org/0000-0003-4326-0673

Jae-Woo Jung
https://orcid.org/0000-0002-3411-735X

Min-Jong Kang
https://orcid.org/0000-0003-3245-144X

Deog Kyeom Kim
https://orcid.org/0000-0001-9379-8098

Hayoung Choi
https://orcid.org/0000-0003-4812-0653

Young-Jae Cho
https://orcid.org/0000-0001-6943-4462

Seung Hun Jang
https://orcid.org/0000-0001-5457-5780

Chang-Hoon Lee
https://orcid.org/0000-0001-9960-1524

Yeon Mok Oh
https://orcid.org/0000-0003-0116-4683

Ji Sook Park
https://orcid.org/0000-0002-9479-6710

Jae Yeol Kim
https://orcid.org/0000-0003-3631-4610

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