Eosinophils and chronic obstructive pulmonary diseases (COPD) in hospitalized COVID-19 patients – BMC Infectious … – BMC Infectious Diseases

Study design and participants

This cross-sectional study was conducted on COPD inpatients infected by SARS-CoV-2 at Afzalipour Hospital, Kerman, Iran, from January to July 2022. According to reference [14], in people with COVID-19, the frequency of eosinopenia was 53%, with an error of d=0.3, p=0.05 and =0.05, the sample size was equal to 50 people using the sample size formula for a population. In order to improve the results, increase the statistical power of the test and the possibility of dropping samples, 100 people were examined. Then six patients declined to participate in study and four patients had left the hospital with satisfaction. After that, 49 and 41 people were allocated to non-eosinophilia and eosinophilia group. 11 people in non-eosinophilia group and 6 people in eosinophilia group were lost to follow-up. Finally, 73 people remained in the study (38 in non-eosinophilia and 35 in eosinophilia group) (Fig. 1).

The patients were selected by random sampling. The inclusion criteria were age 40 years and older, positive throat and nose reverse transcriptase polymerase chain reaction (RT-PCR) test for COVID-19, history of COPD, and informed consent to enter the study. Also patients with clinical signs of pneumonia (i.e., fever, cough, and dyspnea) and SPO2 90% on room air were classified as non-severe cases and patients with clinical signs of pneumonia (i.e., fever, cough, and dyspnea) and at least one of the following signs were classified as severe cases: respiratory rate> 30 breaths/minute, severe respiratory distress, SpO2 < 90% on room air, shock, or other organ failures included in study. The exclusion criteria were known immunodeficiency (patients who used immunosuppressive drugs before the diagnosis of COVID-19), previous diagnosis or clinical symptoms consistent with asthma, cancer, oral corticosteroid use before hospitalization, and lack of cooperation or consent to participate in the study.

Immediately after positive PCR test, a 7-cc peripheral blood sample was taken from each hospitalized COPD patient infected by COVID-19 to test hematological parameters, including erythrocyte sedimentation rate (ESR), white blood cells (WBC), lactate dehydrogenase(LDH), D-dimer, hemoglobin (HB), hematocrit (HCT), mean corpuscular volume (MCV), platelets (PLT), neutrophils (NEUT%) and lymphocytes (LYMPH%). Peripheral blood slides were stained using Giemsa staining to determine the eosinophil percentage. Oxygen saturation on admission and discharge days (SPO21 and SPO22, respectively) was measured by pulse oximetry when the patient did not receive oxygen therapy.

The patients demographic information, including age, gender, history of smoking and inhaling opium, past medical history, oxygen therapy methods, CT scan information, and treatment outcomes, was extracted from patients records.

Chest CT was performed using a Philips Diamond Select Brilliance CT scanner (made in the USA). The radiologists reported the CT scans, then an expert pulmonologist who was blinded to the patients laboratory results, read and reported all the CT scans based on the scoring of reference [19].

The severity of pulmonary involvement was determined based on chest CT severity score (CT-SS) (based on the degree of involvement of the lung lobes, 0%: 0 points, 125%: 1 point, 2650%: 2 points, 5175%: 3 points, and 76100%: 4 points). The CT-SS was the sum of the scores of the five lobes (range 020) [19].

According to the WHO disease severity classification, patients were divided into severe and non-severe COVID-19 groups. Patients with clinical signs of pneumonia (i.e., fever, cough, and dyspnea) and SPO2 90% on room air were classified as non-severe cases and patients with clinical signs of pneumonia (i.e., fever, cough, and dyspnea) and at least one of the following signs were classified as severe cases: respiratory rate> 30 breaths/minute, severe respiratory distress, SpO2 < 90% on room air, shock, or other organ failures [20].

Eosinophilia was defined as eosinophil levels 2% and non-eosinophilia as eosinophil levels< 2%.

This study has been approved by the ethics committee of Kerman University of Medical Sciences (Code: IR.KMU.AH.REC.1400.254). Written informed consent was obtained from each participant.

Descriptive statistics (frequency, relative frequency, mean, and standard deviation), analytical statistics (chi-square test and independent t-test), and SPSS software version 20 were used to analyze the data. The significance level considered was P 0.05.

Visit link:

Eosinophils and chronic obstructive pulmonary diseases (COPD) in hospitalized COVID-19 patients - BMC Infectious ... - BMC Infectious Diseases