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Association between blood eosinophils with exacerbation and patient-reported outcomes in chronic obstructive pulmonary disease patients in an endemic area for parasitic infections: a prospective study.

Abstract：

Background:Eosinophilic chronic obstructive pulmonary disease (COPD) patients have eosinophilic airway inflammation. No prospective study has reported blood eosinophil counts in an endemic area for parasitic infection. The primary objective was to compare exacerbation rates. The secondary objectives were patient-reported outcomes between eosinophilic and non-eosinophilic COPD. Methods:A prospective study was conducted in COPD patients for 52 weeks. COPD was diagnosed according to GOLD criteria. Blood eosinophil counts were recorded at study entry. Exacerbations were recorded during the entire study period whereas COPD Assessment Test (CAT) and spirometry were recorded at 12 months. The eosinophilic and non-eosinophilic groups were defined by blood eosinophil counts ≥300 and <300 cells/µL, respectively. Results:A total of 145 COPD patients were included. Fifty-eight (40%) and 87 (60%) patients were eosinophilic and non-eosinophilic COPD and the median [interquartile range (IQR)] eosinophil counts were 481 [378.5, 675] and 149 [101.2, 208] cells/µL, respectively. The median (IQR) annual exacerbation rates were 3 [2, 4] and 2 [2, 2.5] times/year in the eosinophilic and non-eosinophilic groups, respectively (P=0.024). The eosinophilic group had higher admissions (P=0.007) but lower mortality (P=0.041). The patient-reported outcomes were not statistically significantly different between the two groups. Eosinophil counts ≥300 cells/µL identified exacerbation in COPD patients with sensitivity and specificity of 0.71 and 0.64, respectively. Conclusions:COPD patients with blood eosinophil counts ≥300 cells/µL had more exacerbations and admissions but lower mortality than the non-eosinophilic patients. Blood eosinophil count is an effective biomarker to predict exacerbation risk in endemic parasitic areas. Trial registration:NCT04123028 at ClinicalTrials.gov.

journal_name

J Thorac Dis

journal_title

Journal of thoracic disease

authors

Juthong S,Kaenmuang P

doi

10.21037/jtd-19-4101

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

4868-4876

issue

eissn

2072-1439

issn

2077-6624

pii

jtd-12-09-4868

journal_volume

pub_type

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Association between blood eosinophils with exacerbation and patient-reported outcomes in chronic obstructive pulmonary disease patients in an endemic area for parasitic infections: a prospective study.