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Eosinophil recovery in hospitalized COVID-19 patients is associated with lower rates of ICU admission and in-hospital mortality: An observational cohort analysis.
Yan, Peter D; Markovic, Daniela; Hixson, Roxana Y; Shover, Carolyn M; Buhr, Russell G; Salehi-Rad, Ramin; LeMaster, Blake; Tashkin, Donald P; Fulcher, Jennifer A; Barjaktarevic, Igor Z.
Afiliação
  • Yan PD; David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
  • Markovic D; Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
  • Hixson RY; Division of Pulmonary, Critical Care and Sleep Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
  • Shover CM; Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, United States; Offsite Care, Santa Rosa, CA, United States.
  • Buhr RG; Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, United States; Department of Medicine, Greater Los Angeles Veterans Affairs Health Care System, Los Angeles, CA, United States.
  • Salehi-Rad R; Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, United States; Department of Medicine, Greater Los Angeles Veterans Affairs Health Care System, Los Angeles, CA, United States.
  • LeMaster B; Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.
  • Tashkin DP; Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
  • Fulcher JA; Department of Medicine, Greater Los Angeles Veterans Affairs Health Care System, Los Angeles, CA, United States; Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
  • Barjaktarevic IZ; Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, United States. Electronic address: ibarjaktarevic@mednet.ucla.edu.
Respir Med Res ; 84: 101031, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37647739
BACKGROUND: Admission eosinopenia (<100 cells/µL) is associated with poor clinical outcomes in hospitalized COVID-19 patients. However, the effects of eosinophil recovery (defined as reaching ≥50 eosinophils/µL) during hospitalization on COVID-19 outcomes have been inconsistent. METHODS: The study included 1,831 patients admitted to UCLA hospitals between February 2020 and February 2021 with PCR-confirmed COVID-19. Using competing risk regression and modeling eosinophil recovery as a time-dependent covariate, we evaluated the longitudinal relationship between eosinophil recovery and in-hospital outcomes including ICU admission, need for mechanical ventilation, and in-hospital mortality. All analyses were adjusted for covariates including age, BMI, tobacco smoke exposure, comorbidities known to be risk factors for COVID-19 mortality, and treatments including dexamethasone and remdesivir. RESULTS: Eosinophil recovery was evaluated in patients with <50 eosinophils/µL on admission (n = 1282). These patients cumulatively amassed 11,633 hospital patient-days; 3,985 of those days qualified as eosinophil recovery events, which were represented by 781 patients achieving at least one instance of eosinophil recovery during hospitalization. Despite no significant difference in the rate of mechanical ventilation, eosinophil recoverers had significantly lower rates of in-hospital mortality (aHR: 0.44 [0.29, 0.65], P = 0.001) and ICU admission (aHR: 0.25 [0.11, 0.61], P = 0.002). CONCLUSION: Trending eosinophil counts during hospitalization is simple and can be performed in resource-limited healthcare settings to track the inflammatory status of a patient. Lack of eosinophil recovery events can identify those at risk for future progression to severe COVID.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eosinófilos / COVID-19 Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Respir Med Res Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eosinófilos / COVID-19 Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Respir Med Res Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos