Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Eosinophilia Is a Favorable Marker for Pneumonia in Chronic Obstructive Pulmonary Disease

  • Kang-Mo Gu (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Jae-Woo Jung (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Min-Jong Kang (Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine) ;
  • Deog Kyeom Kim (Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine) ;
  • Hayoung Choi (Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital) ;
  • Young-Jae Cho (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Seung Hun Jang (Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital) ;
  • Chang-Hoon Lee (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Yeon Mok Oh (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ji Sook Park (Department of Software Convergence, Seoul Women's University College of Interdisciplinary Studies for Emerging Industries) ;
  • Jae Yeol Kim (Department of Internal Medicine, Chung-Ang University College of Medicine)
  • Received : 2023.10.27
  • Accepted : 2024.04.29
  • Published : 2024.10.31
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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.

Keywords

Acknowledgement

This study was supported by Pfizer Grant WI221325.

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