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Eosinophils are recruited to the heart during acute myocardial infarction (MI) and are considered part of the inflammatory response associated with adverse clinical outcomes. We assessed the impact of eosinopenia on cardiac imaging biomarkers in patients presenting with ST-segment elevation MI. This is a post-hoc analysis of the Evaluating the effectiveness of intravenous Ciclosporin on reducing reperfusion injury in pAtients undergoing PRImary percutaneous coronary intervention (CAPRI) trial. Patients underwent cardiac MRI within 1 week and 12 weeks and low eosinophil was defined as less than 40 cells/ml. The study included 52 patients and 38% had low eosinophil. Ciclosporin administration was comparable between patients with low versus normal eosinophils. The ischaemia time was significantly longer in low eosinophil patients [262 (205–325) vs. 138 (102–195) minutes, P < 0.001]. At 12 weeks, patients with eosinopenia had larger infarct size [9.8% (5.7–18.4) vs. 7.4% (1.9–10.2), P = 0.045], larger left ventricle (LV) end systolic volume (89 ± 28 vs. 68 ± 23, P = 0.02), and lower LV ejection fraction (EF) (49 ± 9 vs. 58 ± 7, P < 0.001). After adjustments for significant predictors, including ischaemia time, low eosinophil count was an independent predictor of worse LVEF at 12 weeks [-5.78, 95% CI (-11.22 to -0.34), P = 0.038] but not infarct size [1.83, 95% CI (-2.77 to 6.43), P = 0.43]. Patients with low eosinophil count had larger infarct size and LV volumes and worse adverse remodeling compared to those with normal eosinophil count. At 12 weeks, eosinopenia was an independent predictor of worse LVEF but not infarct size. [ABSTRACT FROM AUTHOR]

Background Biomarkers like sarcopenia, eosinopenia and C-reactive protein (CRP) may predict major adverse events including intubation, ICU admission, mortality and readmission in chronic obstructive pulmonary disease (COPD) exacerbations. We aimed to determine their prognostic utility and accuracy. Methods This was a prospective analysis of COPD patients hospitalised for acute exacerbation over one year. Patients with primary diagnoses other than COPD were excluded. Patients were screened to select a sample of 205 participants, with 55 experiencing adverse events including intubation, ICU admission, in-hospital mortality and 30-day readmission. Data on demographics, lung function, symptoms, nutrition, frailty, sarcopenia, eosinophil-to-platelet ratio (EPR) and CRP were extracted. Differences between groups were analysed using t-tests and regression modelling. Results EPR

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Background: Biomarkers like sarcopenia, eosinopenia and C-reactive protein (CRP) may predict major adverse events including intubation, ICU admission, mortality and readmission in chronic obstructive pulmonary disease (COPD) exacerbations. We aimed to determine their prognostic utility and accuracy. Methods: This was a prospective analysis of COPD patients hospitalised for acute exacerbation over one year. Patients with primary diagnoses other than COPD were excluded. Patients were screened to select a sample of 205 participants, with 55 experiencing adverse events including intubation, ICU admission, in-hospital mortality and 30-day readmission. Data on demographics, lung function, symptoms, nutrition, frailty, sarcopenia, eosinophil-to-platelet ratio (EPR) and CRP were extracted. Differences between groups were analysed using t-tests and regression modelling. Results: EPR <0.755 and CRP =15.8 mg/dL were significant predictors of adverse events after adjustment, with EPR having an AUC of 0.79 and CRP an AUC of 0.68 for composite outcomes. In multivariate analysis, sarcopenia, EPR and CRP remained significant with the outcome variables (intubation, ICU admission, in-hospital mortality and 30-day readmission). Conclusion: EPR and CRP are useful prognostic markers of clinically significant in-hospital outcomes during COPD exacerbations. However, a multidimensional approach may further optimise risk prediction. [ABSTRACT FROM AUTHOR]

The article in Clinical & Experimental Allergy explores the connection between lymphopenia, basopenia, and eosinopenia in chronic spontaneous urticaria (CSU) patients, particularly those with autoimmune CSU. The study involved 300 CSU patients and found that lymphopenia was associated with lower counts of basophils, eosinophils, monocytes, and platelets. The research suggests that lymphopenia may reflect the migration of lymphocytes from the bloodstream into skin lesions, similar to basophils and eosinophils. The study also identified associations between basopenia and high anti-C1q levels, supporting the hypothesis that these antibodies may be a marker of autoimmune CSU. [Extracted from the article]

SARS-CoV-2 infection usually results in multi-organ affection, and severe inflammatory response which associated with significant affection of blood cell count and coagulation profile. We aimed to study the changes in haematological parameters among patients infected with SARSCoV2 and its relation to the severity of infection. A retrospective cohort investigated data from patients hospitalized at the Armed Forces Hospital in Jeddah, Saudi Arabia, between July 2020 and July 2022. Patient who tested positive for SARS-CoV 2 infection were compared to negative patients. A total of 586 patients were included, 387 tested positive for SARS-CoV-2. COVID-19 patients had significant lower leukocyte, and eosinophil counts along with lower red blood cell indices, suggesting a potential impact on the hematopoietic system. Deviation in leukocyte count was correlated with disease severity. the mortality was higher in the non-COVID-19 group (14.1 vs. 7.5%). COVID-19 patients had significantly higher fibrinogen levels and lower prothrombin time than non-COVID-19 patients. No difference was found regarding liver enzymes, renal function tests or acute-phase reactants. Haematological parameters could be used as markers for early detection, assessment of disease severity, and prognosis of SARS-CoV-2 infection. Further studies are necessary to understand the underlying mechanisms and their clinical significance. [ABSTRACT FROM AUTHOR]

Introduction: Eosinophils are involved in many metabolic events, such as the provision of homeostasis in the organism, host cell defense, and tissue repair and regeneration. Despite these important roles, eosinophils can be overlooked during the examination of blood tests performed in daily clinical practice. This study aimed to investigate the role of eosinophils in the clinical course of COVID-19. Methods: In this study, patients who presented to the emergency department with symptoms of COVID-19 and had a positive polymerase chain reaction test or typical COVID-19 involvement on thoracic computed tomography were evaluated retrospectively. The patients' demographic data and blood parameters were obtained. In addition, the patients' outcomes, requirements for admission to inpatient wards or the intensive care unit, mechanical ventilation requirements, and in-hospital mortality were recorded and statistically analyzed. Results: The study included a total of 3,845 patients. The eosinophil count was found to be lower in cases requiring hospitalization, intensive care, or mechanical ventilation, and in those with in-hospital mortality. In addition, the eosinophil count was found to be the most significant prognostic factor among all investigated parameters. Discussion and Conclusion: Although eosinophil count is often overlooked, it is one of the factors that determines the prognosis in critically ill patients, as in the case of COVID-19. To the best of our knowledge, this is the first study to investigate the effect of eosinophil count on the course of COVID-19 and compare the utility of eosinophil count with other complete blood count parameters for this purpose. [ABSTRACT FROM AUTHOR]

Latar belakang. Luaran klinis infeksi COVID-19 pada anak baik tetapi angka kematian COVID-19 masih tinggi. Identifikasi derajat keparahan sedini mungkin dapat memberikan luaran klinis yang baik. Beberapa penanda inflamasi pada kasus COVID-19 salah satunya didapatkan eosinopenia. Tetapi hingga saat ini belum ada penelitian tentang hubungan antara eosinopenia terhadap derajat keparahan infeksi COVID-19 pada anak. Tujuan. Menganalisis hubungan eosinopenia terhadap derajat keparahan infeksi COVID-19 pada anak. Metode. Studi cross sectional observasional analitik, data sekunder retrospektif, diambil dari rekam medis pasien usia 0-

Background. Leptospirosis presents diagnostic challenges due to its nonspecific symptoms which often overlap with other febrile illnesses. Identifying reliable clinical predictors could streamline diagnostic processes and improve patient outcomes. Methods. This study analyzed the occurrence of hypocalcemia, eosinopenia, and hypochloremia in 200 patients suspected of having leptospirosis. We conducted a retrospective analysis comparing laboratory values of confirmed leptospirosis cases against those of patients where the disease was ruled out. Results. Preliminary results indicate significant correlations between the presence of these three clinical markers and confirmed cases of leptospirosis. Conclusion. Hypocalcemia, eosinopenia, and hypochloremia show potential as clinical predictors for leptospirosis, suggesting that these markers could be integrated into diagnostic protocols to enhance early detection and treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Mood disorders (MD) are multifactorial disorders. Identifying new biomarkers for the early diagnosis of MD and predicting response to treatment is currently a significant research topic. Both eosinopenia and MD are associated with increased activity of the hypothalamic-pituitary-adrenal axis. The present study, therefore, used a clear definition of chronic idiopathic eosinopenia (CIE) to determine the rate of MD in a large cohort of individuals with CIE. Methods: This retrospective population-based, case-control study uses data of seven consecutive years from the database of Leumit Health Services (LHS) - a nationwide health maintenance organization in Israel. Results: Participants were 13928 LHS members with CIE and 27858 negative controls. The CIE group exhibited significantly higher rates of MD than the control group throughout the whole study period, except for atypical depressive disorder at baseline. Conclusions: CIE might be associated with a higher prevalence of MD. Further basic research should elucidate the pathophysiologic mechanisms linking CIE and MD.

Introduction: Sepsis continues to be a leading cause of mortality and prolonged hospitalisation. The conventional method of blood culture, while considered the gold standard, has limitations such as contamination and delayed reporting. The examination of peripheral smears has uncovered signs suggestive of septicaemia; however, these findings suffer from inter-observer variability and reliance on staining quality. Aim: To investigate the variation of neutrophil and monocyte parameters, including Volume, Conductivity, and Scatter (VCS), in sepsis compared to healthy controls. Materials and Methods: A cross-sectional analytical study was conducted at the Himalayan Institute of Medical Sciences, Swami Rama Himalayan University in Dehradun, Uttarakhand, over the course of one year, from January 2021 to December 2021, involving patients over 18 years of age categorised into sepsis group based on clinical suspicion, sepsis screen, blood culture, and Sequential Organ Failure Assessment (SOFA) score (n=117). A group of healthy controls was also included (n=140). Haematological investigations were performed using the DXH 800 Haematology Analyser (Beckman Coulter, CA, USA) with VCS Technology. Categorical variables were analysed using the Chi-square test, while non parametric data was compared using the Mann-Whitney U test. Results: The average age in the sepsis group was 50.17±13.17 years, while in the control group, it was 38.14±8.78 years. The results revealed higher White Blood Cell (WBC) counts (16.76±7.39)×103/cumm in the sepsis group compared to healthy controls (6.68±1.42)×103, absolute neutrophil counts (13.74±7.280)×103 in sepsis patients, and eosinopenia in the sepsis group (0.0114±0.0104)×103 compared to controls (0.23±0.116)×103. Moreover, mean neutrophilic volumes (158.00±14.840) and monocytic volumes (182.58±18.64) were higher in the sepsis group, while they were lower in healthy controls, which were (149.52±5.23 and 171.17±6.28), respectively. Axial light loss for neutrophil and monocyte was 142.40±11.78 and 121.50±17.93, respectively, while it was lower in healthy controls showing a value of 135.51±7.63 and 119.45±8.25, respectively. Furthermore, mean neutrophilic and monocytic conductivity and scatter were decreased in sepsis. The observed higher WBC counts and absolute neutrophil counts in sepsis patients suggest a premature release of neutrophils from the bone marrow. The alterations in cell volume reflect an immune response. Additionally, the overall scatter of neutrophils and monocytes was reduced, accompanied by increased cellular transparency. Conclusion: The present study contributes valuable insights into the pathophysiological mechanisms underlying sepsis, emphasising the dynamic interplay between immune cells and their functional characteristics. Understanding these variations in cellular parameters could potentially aid in the development of more targeted diagnostic and therapeutic approaches for sepsis, ultimately improving patient outcomes. Further research is warranted to delve deeper into the specific mechanisms driving these observed changes and to explore their clinical implications in the context of sepsis management.

Background: Understanding COVID-19 outcomes remains a challenge. While numerous biomarkers have been proposed for severity at admission, limited exploration exists for markers during the infection course, especially for the requirement of oxygen therapy. This study investigates the potential of eosinophil count normalization as a predictor for oxygen weaning during the initial wave of the pandemic. Methods: A retrospective study was conducted between March and April 2020 (first wave) among adults admitted directly to a medicine ward. Biological abnormalities, including lymphocyte count, eosinophil count, and C-reactive protein (CRP), were gathered daily during the first week of admission according to oxygen level. In case of worsening, oxygen level was censored at 15 L/min. The primary aim was to assess whether eosinophil count normalization predicts a subsequent decrease in oxygen requirements. Results: Overall, 132 patients were admitted, with a mean age of 59.0 ± 16.3 years. Of the patients, 72% required oxygen, and 20.5% were admitted to the intensive care unit after a median delay of 48 hours. The median CRP at admission was 79 (26-130) mg/L, whereas the eosinophil count was 10 (0-60)/mm³. Eosinophil count normalization (=100/mm³) by day 2 correlated significantly with decreased oxygen needs (<2 L) with hazard ratio (HR) = 3.7 [1.1-12.9] (p = 0.04). Likewise, CRP < 80 mg/L was associated with reduced oxygen requirements (p < 0.001). Predictors, including underlying chronic respiratory disease, exhibited a trend toward a negative association (p = 0.06). Conclusion: The study highlights the relationship between eosinophil count and CRP, with implications for predicting oxygen weaning during COVID-19. Further research is warranted to explore the relevance of these biomarkers in other respiratory infections. [ABSTRACT FROM AUTHOR]

Introduction: Necrotizing otitis externa (NOE) is a serious, progressive, and potentially life‐threatening infection of the external auditory canal, affecting soft tissue and bone. The most common organism causing NOE is Pseudomonas Aeruginosa and less common are Fungal infections. When managing a patient with NOE, a culture is taken from the EAC in order to tailor the appropriate antimicrobial treatment, however commonly, the culture is sterile. Inflammation biomarkers may be used as adjuncts to inform on the differential diagnosis and as prognostic markers. Aim: To characterize and compare values and ratios of components of the complete blood count (CBC) at admission, at patients with positive swab culture. Methods: A retrospective study of NOE patients was conducted. We included all patients admitted between the years 2001‐2023, for whom a culture swab tested positive. We compared CBC findings at hospitalization between bacteria and fungi‐positive culture patients. Results: Eosinophils‐to‐Neutrophils Ratio (ENR) was significantly lower in the fungal group compared to the bacterial group 0.023 ± 0.02 and 0.04 ± 0.03, respectively (p‐value = 0.025). Eosinophils‐to‐Leukocyte Ratio (ELR) was significantly lower in the fungal group compared to the bacterial group 0.058 ± 0.04 and 0.12 ± 0.1 respectively (p‐value = 0.009). For definition of ELR ≤ 0.1 we found that, sensitivity was 88% (95%CI = 0.679‐0.979) and NPV 90% (95%CI = 0.709‐0.982). For definition of ENR ≤ 0.03 sensitivity was 88% (95%CI = 0.679‐0.979) and NPV 88% (95%CI = 0.679‐0.979). Conclusion: Lower values of ELR and ENR in patients with NOE are associated with fungal infection and can serve as a tool in adjusting an appropriate antimicrobial therapy in cases of sterile or when no culture is available. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis continues to be a leading cause of mortality and prolonged hospitalisation. The conventional method of blood culture, while considered the gold standard, has limitations such as contamination and delayed reporting. The examination of peripheral smears has uncovered signs suggestive of septicaemia; however, these findings suffer from inter-observer variability and reliance on staining quality. Aim: To investigate the variation of neutrophil and monocyte parameters, including Volume, Conductivity, and Scatter (VCS), in sepsis compared to healthy controls. Materials and Methods: A cross-sectional analytical study was conducted at the Himalayan Institute of Medical Sciences, Swami Rama Himalayan University in Dehradun, Uttarakhand, over the course of one year, from January 2021 to December 2021, involving patients over 18 years of age categorised into sepsis group based on clinical suspicion, sepsis screen, blood culture, and Sequential Organ Failure Assessment (SOFA) score (n=117). A group of healthy controls was also included (n=140). Haematological investigations were performed using the DXH 800 Haematology Analyser (Beckman Coulter, CA, USA) with VCS Technology. Categorical variables were analysed using the Chi-square test, while non parametric data was compared using the Mann-Whitney U test. Results: The average age in the sepsis group was 50.17±13.17 years, while in the control group, it was 38.14±8.78 years. The results revealed higher White Blood Cell (WBC) counts (16.76±7.39)×103/cumm in the sepsis group compared to healthy controls (6.68±1.42)×103, absolute neutrophil counts (13.74±7.280)×103 in sepsis patients, and eosinopenia in the sepsis group (0.0114±0.0104)×103 compared to controls (0.23±0.116)×103. Moreover, mean neutrophilic volumes (158.00±14.840) and monocytic volumes (182.58±18.64) were higher in the sepsis group, while they were lower in healthy controls, which were (149.52±5.23 and 171.17±6.28), respectively. Axial light loss for neutrophil and monocyte was 142.40±11.78 and 121.50±17.93, respectively, while it was lower in healthy controls showing a value of 135.51±7.63 and 119.45±8.25, respectively. Furthermore, mean neutrophilic and monocytic conductivity and scatter were decreased in sepsis. The observed higher WBC counts and absolute neutrophil counts in sepsis patients suggest a premature release of neutrophils from the bone marrow. The alterations in cell volume reflect an immune response. Additionally, the overall scatter of neutrophils and monocytes was reduced, accompanied by increased cellular transparency. Conclusion: The present study contributes valuable insights into the pathophysiological mechanisms underlying sepsis, emphasising the dynamic interplay between immune cells and their functional characteristics. Understanding these variations in cellular parameters could potentially aid in the development of more targeted diagnostic and therapeutic approaches for sepsis, ultimately improving patient outcomes. Further research is warranted to delve deeper into the specific mechanisms driving these observed changes and to explore their clinical implications in the context of sepsis management. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence of hematologic findings and the relationship between hemogram parameters and brucellosis stages in patients. Methods: This multi-center study included patients older than 16 years of age who were followed up with a diagnosis of brucellosis. Patients' results, including white blood cell, hemoglobin, neutrophil, lymphocyte, monocyte, mean platelet volume, platelet and eosinophil counts were analyzed at the initial diagnosis. Results: In this study 51.3% of the patients diagnosed with brucellosis were male. The age median was 45 years for female and 41 years for male. A total of 55.1% of the patients had acute brucellosis, 28.2% had subacute, 7.4% had chronic and 9% had relapse. The most common hematologic findings in brucellosis patients were anemia (25.9%), monocytosis (15.9%), eosinopenia (10.3%), and leukocytosis (7.1%). Pancytopenia occurred in 0.8% of patients and was more prominent in the acute phase. The acute brucellosis group had lower white blood cell, hemoglobin, neutrophil, eosinophil, and platelet counts and mean platelet volume, and higher monocyte counts compared to subacute and chronic subgroups. Conclusion: It was noteworthy that in addition to anemia and monocytosis, eosinopenia was third most prominent laboratory findings in the study. Pancytopenia and thrombocytopenia rates were low. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 Omicron variant became predominant in Turkey in January 2022, coinciding with a rise in SARS-CoV-2–associated hospitalizations. Material and methods. Patients diagnosed with COVID-19 were collected by the infection control committee through an active surveillance program for COVID-19 throughout the pandemic. The hospitalization rate was included in the model to evaluate the relationship between each wave period and disease severity. The basic demographic data of the patients, and the potential risk factors such as comorbid diseases, and laboratory findings were included in the analysis. Results. The rate of patients who were positive in August (26.8%) was found to be significantly lower than in February (45.9%) (p<.001). The proportion of inpatient patients treatment in August (2.3%) was found to be significantly higher than in February (1.2%) (p<.001). In addition, in the omicron variant patients' wave, the neutrophil/lymphocyte ratio was 5.31; and it was observed to be significantly higher than that of the patients (Median = 3.95) in the delta variant wave (p=.023). Discussion. These results provide clinicians with information about the clinical course of COVID-19 patients and are very important for appropriate clinical decision-making in these patients. It is critical to continue to update COVID-19 management protocols based on the latest research. [ABSTRACT FROM AUTHOR]

Background: The Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) score at presentation is designed to predict the risk of death in patients with chronic obstructive pulmonary disease (COPD). Aims and Objectives: To study the DECAF score at admission to predict the clinical outcome of the patients during hospitalization for acute exacerbation of COPD (AE-COPD). Materials and Methods: The study was conducted using a prospective cross-sectional observational study design in a tertiary care center in South India from April 2022 to March 2023. Patients were recruited based on specific inclusion and exclusion criteria. The data corresponding to the five variables of the DECAF score was obtained, and the relation to outcome measures such as survival, ventilation, and duration of stay was measured. Results: Two hundred consecutive patients were assessed. Based on the DECAF score, 102 patients (51%) were classified as low-risk, and this group had no mortalities. In the intermediate-risk group, the mortality rate was 7.4%; in the high-risk group, the observed mortality rate was 38.6%. The differences noted were significant statistically. Higher dyspnea grade as measured by extended Modified Research Council criteria was related to DECAF score was significant and with the outcome. Conclusion: Our study shows that the DECAF score at the initial presentation can be used as a reliable tool to predict the outcome of AE-COPD. Dyspnea grading can be used to predict mortality indirectly.

Abstract Background The incidence of sepsis increases significantly with age, including a high incidence of bacterial infection in the old adults. Eosinopenia and the CIBLE score have been proposed in critically ill adults and in internal medicine wards. This study aimed to assess whether a low eosinophil count was associated with acute bacterial infection among hospitalized older adults, and to find the most efficient eosinophil count cut-off to differentiate acute bacterial infection from other inflammatory states. Methods This was a prospective study from July 2020 to July 2022 in geriatric wards of the University Paul Brousse Hospital (Villejuif, France) including patients aged of 75 y/o or over suffering from fever or biological inflammation. Acute bacterial infection was assessed using biological identification and/or clinical and radiological data. Results A total of 156 patients were included. Eighty-two (53%) patients suffered from acute bacterial infection (mean age (SD) 88.7 (5.9)). Low eosinophil count was independently associated with acute bacterial infection: OR [CI95%] 3.03 [1.04–9.37] and 6.08 [2.42–16.5] for eosinophil count 0–0.07 G/L and 0.07–0.172 G/L respectively (vs. eosinophil count > 0.172 G/L). Specificity and sensitivity for eosinophil count

OBJECTIVE: To assess eosinopenia and neutrophil to lymphocyte ratio in patients admitted with COVID-19 infection and correlate with pneumonia severity. METHODOLOGY: This prospective observational study was conducted at Covid HDU of Dr. Ruth KM Pfau Civil Hospital, Karachi, from October - December 2021. Data was collected using convenience sampling. The inclusion criteria were patients between 18-70 years with symptoms suggestive of COVID-19 and positive RT-PCR. Patients with negative RT-PCR with alternate diagnosis, history of using a corticosteroid, pancreatic or esophageal malignancy, and recent burn were excluded. Data analysis was done using SPSS version 23. RESULTS: Out of 141 patients, 66(46%) were classified as non-severe covid and 75(53.9%) as severe covid pneumonia. A significant association between eosinopenia and COVID severity was observed. The NLR was significantly increased in severe COVID patients compared to non-severe patients. Similarly, eosinophil was decreased considerably in severe covid compared to non-severe patients (p-value

BackgroundUnderstanding COVID-19 outcomes remains a challenge. While numerous biomarkers have been proposed for severity at admission, limited exploration exists for markers during the infection course, especially for the requirement of oxygen therapy. This study investigates the potential of eosinophil count normalization as a predictor for oxygen weaning during the initial wave of the pandemic.MethodsA retrospective study was conducted between March and April 2020 (first wave) among adults admitted directly to a medicine ward. Biological abnormalities, including lymphocyte count, eosinophil count, and C-reactive protein (CRP), were gathered daily during the first week of admission according to oxygen level. In case of worsening, oxygen level was censored at 15 L/min. The primary aim was to assess whether eosinophil count normalization predicts a subsequent decrease in oxygen requirements.ResultsOverall, 132 patients were admitted, with a mean age of 59.0 ± 16.3 years. Of the patients, 72% required oxygen, and 20.5% were admitted to the intensive care unit after a median delay of 48 hours. The median CRP at admission was 79 (26–130) mg/L, whereas the eosinophil count was 10 (0–60)/mm3. Eosinophil count normalization (≥100/mm3) by day 2 correlated significantly with decreased oxygen needs (

Background: The Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) score at presentation is designed to predict the risk of death in patients with chronic obstructive pulmonary disease (COPD). Aims and Objectives: To study the DECAF score at admission to predict the clinical outcome of the patients during hospitalization for acute exacerbation of COPD (AE-COPD). Materials and Methods: The study was conducted using a prospective cross-sectional observational study design in a tertiary care center in South India from April 2022 to March 2023. Patients were recruited based on specific inclusion and exclusion criteria. The data corresponding to the five variables of the DECAF score was obtained, and the relation to outcome measures such as survival, ventilation, and duration of stay was measured. Results: Two hundred consecutive patients were assessed. Based on the DECAF score, 102 patients (51%) were classified as low-risk, and this group had no mortalities. In the intermediate-risk group, the mortality rate was 7.4%; in the high-risk group, the observed mortality rate was 38.6%. The differences noted were significant statistically. Higher dyspnea grade as measured by extended Modified Research Council criteria was related to DECAF score was significant and with the outcome. Conclusion: Our study shows that the DECAF score at the initial presentation can be used as a reliable tool to predict the outcome of AE-COPD. Dyspnea grading can be used to predict mortality indirectly. [ABSTRACT FROM AUTHOR]

This study examined the distinctions between multisystem inflammatory syndrome associated with coronavirus disease 2019, Kawasaki disease, and infectious mononucleosis. These three inflammatory disorders have commonalities according to clinical and laboratory results, particularly in relation to eosinophil levels. In this retrospective, single-center study, we documented the examination records (acute phase reactants and complete blood count) and clinical and cardiological findings of 130 patients diagnosed with multisystem inflammatory syndrome, Kawasaki disease, and infectious mononucleosis. These patients were treated and received follow-up care in our hospital from March 12, 2020, to September 13, 2022, as per the hospital records. Statistical analyses were performed using NCSS 2007, version 1 software. Eosinopenia was more prevalent in children with multisystem inflammatory syndrome than in those with Kawasaki disease, who showed normal or elevated eosinophil counts. The eosinophil counts in patients with infectious mononucleosis typically fell within the normal range. Our study found no correlation between the eosinophil counts and cardiac involvement in pediatric patients with either condition. These findings indicate a higher prevalence of eosinopenia in patients with multisystem inflammatory syndrome, irrespective of cardiac involvement, than in those with Kawasaki disease. Despite similarities in clinical findings, Kawasaki disease and multisystem inflammatory syndrome in children necessitate further studies for distinct characteristic elucidation. [ABSTRACT FROM AUTHOR]

Background: Current guidelines prioritize the use of Azvudine in Coronavirus Disease 2019 (COVID-19) patients, while biomarkers for prognosis in Azvudinetreated COVID-19 patients are still lacking. Here, we aim to assess the prognostic value of eosinopenia in Azvudine-treated COVID-19 patients. Methods: We retrospectively reviewed 290 consecutive Azvudine-treated hospitalized COVID-19 patients. Clinical characteristics and prognosis data were analyzed between patients with eosinopenia and with normal eosinophil levels. Results: A total of 290 patientswere enrolled in this study, with a median age of 69 years. Among them, 40.69% presented with eosinopenia and 59.31% had normal eosinophil levels. Common symptoms included cough (87.6%), expectoration (76.2%), fever (67.9%), poor appetite (47.2%), and polypnea (46.6%). Compared to patients with normal eosinophil levels, those with eosinopenia were older and less likely to experience fatigue (25.4% vs. 39.0%, P=0.016). Significant differences in laboratory parameters, particularly in blood routine and blood biochemical indicators, were observed between the two groups. Patients with eosinopenia were also less likely to develop severe illness subtypes, requiring more medication and oxygen support. The Cox proportional hazardmodel showed that eosinopenia was associated with worsening progression in Azvudine-treated COVID-19 patients (adjusted hazard ratio=2.79, 95% confidence interval: 1.04, 7.50), adjusting for potential confounders. Conclusion: Eosinopenia is associated with worsening prognosis in Azvudinetreated COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: The incidence of sepsis increases significantly with age, including a high incidence of bacterial infection in the old adults. Eosinopenia and the CIBLE score have been proposed in critically ill adults and in internal medicine wards. This study aimed to assess whether a low eosinophil count was associated with acute bacterial infection among hospitalized older adults, and to find the most efficient eosinophil count cut-off to differentiate acute bacterial infection from other inflammatory states. Methods: This was a prospective study from July 2020 to July 2022 in geriatric wards of the University Paul Brousse Hospital (Villejuif, France) including patients aged of 75 y/o or over suffering from fever or biological inflammation. Acute bacterial infection was assessed using biological identification and/or clinical and radiological data. Results: A total of 156 patients were included. Eighty-two (53%) patients suffered from acute bacterial infection (mean age (SD) 88.7 (5.9)). Low eosinophil count was independently associated with acute bacterial infection: OR [CI95%] 3.03 [1.04–9.37] and 6.08 [2.42–16.5] for eosinophil count 0–0.07 G/L and 0.07–0.172 G/L respectively (vs. eosinophil count > 0.172 G/L). Specificity and sensitivity for eosinophil count < 0.01 G/L and CIBLE score were 84%-49% and 72%-62%, respectively with equivalent AUCs (0.66 and 0.67). Conclusion: Eosinophil count < 0.01 G/L is a simple, routinely used and inexpensive tool which can easily participate in antibiotic decisions for older adults. Further studies are needed to assess clinical benefits. Trial registration: The study was registered at Clinical trial.gov (NCT04363138–23/04/2020). [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess eosinopenia and neutrophil to lymphocyte ratio in patients admitted with COVID-19 infection and correlate with pneumonia severity. METHODOLOGY: This prospective observational study was conducted at Covid HDU of Dr. Ruth KM Pfau Civil Hospital, Karachi, from October - December 2021. Data was collected using convenience sampling. The inclusion criteria were patients between 18-70 years with symptoms suggestive of COVID-19 and positive RT-PCR. Patients with negative RT-PCR with alternate diagnosis, history of using a corticosteroid, pancreatic or esophageal malignancy, and recent burn were excluded. Data analysis was done using SPSS version 23. RESULTS: Out of 141 patients, 66(46%) were classified as non-severe covid and 75(53.9%) as severe covid pneumonia. A significant association between eosinopenia and COVID severity was observed. The NLR was significantly increased in severe COVID patients compared to non-severe patients. Similarly, eosinophil was decreased considerably in severe covid compared to non-severe patients (p-value<0.05). The area under the eosinopenia ROC curve is 0.71 and 0.69 on days 7 and 3, respectively. Thus, eosinopenia on day 7 was fair in predicting severe COVID-19 pneumonia compared with increased NLR, which was poor in predicting severe COVID-19. Using the area under the ROC curve, an eosinophil count cutoff of <100 cells/mm3 produced a sensitivity of 75% for severe COVID-19 pneumonia. CONCLUSION: Eosinopenia and elevated NLR were found with increased frequency in patients with severe COVID-19 pneumonia; however, persistent eosinopenia was a better marker than NLR in predicting COVID-19 infection severity. [ABSTRACT FROM AUTHOR]

With the end of the pandemic, COVID-19 has entered an endemic phase with expected seasonal spikes. Consequently, the implementation of easily accessible prognostic biomarkers for patients with COVID-19 remains an important area of research. In this monocentric study at a German tertiary care hospital, we determined the prognostic performance of different clinical and blood-based parameters in 412 COVID-19 patients. We evaluated the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP, 0/µL) of COVID-19 patients (n = 412). The Siddiqui and Mehra staging proposal, the WHO clinical progression scale, and COVID-19-associated death were used as COVID-19 outcome measures. With respect to Siddiqi and Mehra staging, patient age of older than 75 years, high C-reactive protein (CRP), absolute eosinopenia (AEP), cardiovascular comorbidities, and high ferritin were significant independent predictors for severe COVID-19. When outcome was determined according to the WHO clinical progression scale, patient age of older than 75 years, high CRP, high LDH, AEP, high neutrophil-to-lymphocyte ratio (NLR), and the presence of pulmonal comorbidities were significant independent predictors for severe COVID-19. Finally, COVID-19-associated death was predicted independently by patient age of older than 75 years, high LDH, high NLR, and AEP. Eosinopenia (< 40/µL) was observed in 74.5% of patients, and AEP in almost 45%. In conclusion, the present real-world data indicate that the NLR is superior to more complex systemic immune-inflammation biomarkers (e.g., SII and PIV) in COVID-19 prognostication. A decreased eosinophil count emerged as a potential hallmark of COVID-19 infection, whereas AEP turned out to be an accessible independent biomarker for COVID-19 severity and mortality. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Enteric fever remains a leading cause of febrile illness, especially in developing countries. Due to limited resources, all investigations are not available in every health facility, but simpler investigations and clinical examinations may help in the early diagnosis of the disease. In this study, we evaluated the usefulness of eosinopenia and clinical features in predicting enteric fever in children. PATIENTS AND METHODS: A cross-sectional study was conducted from March 2018 to March 2019. A total of 100 children with a fever of a minimum of 5 days duration and without any focus of infection were included in the study. Investigations such as hemogram with absolute eosinophil count, liver function test, Widal test, and blood culture were performed. Absolute eosinopenia was defined as the eosinophilic count of 0 μg/dl. Sensitivity, specificity, PPV, and NPV of absolute eosinopenia and other clinical indicators were calculated. RESULTS: We analyzed data from 100 children, including 75 cases in the enteric fever group (culture/Widal positive) and 25 cases in the suspected enteric fever group. The presence of eosinopenia was statistically significant in the enteric group (p-value = 0.02). Absolute eosinopenia was seen in 52% of confirmed enteric cases, compared to 4% of the suspected enteric group (p-value = 0.001). The positive predictive values for relative bradycardia and coated tongue were 84.3% and 91.4%, respectively. Absolute eosinopenia had a specificity of 96% and PPV of 97.5%. Relative bradycardia, eosinopenia, and absolute eosinopenia were significantly more present in the culture-positive group (p-value = 0.02, 0.04, 0.02, respectively). CONCLUSIONS: Absolute eosinopenia can be used as a strong predictor of the disease and can help in the early institution of appropriate therapy, especially in a resource-limited setting. Relative bradycardia, coated tongue, along with low TLC, thrombocytopenia, and eosinopenia can be used as other predictors.

Keywords: coronavirus disease; COVID-19; eosinopenia; exacerbation; intensive care unit; prognosis EN coronavirus disease COVID-19 eosinopenia exacerbation intensive care unit prognosis 677 680 4 06/19/23 20230701 NES 230701 DATA AVAILABILITY STATEMENT The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Based on Huang's[3] and our results, we recommend closely monitoring COVID-19 patients with moderate level II disease according to Japanese criteria for determining whether patients with Eos = 0 require early transfer to the ICU. In conclusion, Eos = 0 is a risk factor for ICU admission and disease exacerbation, including for transfer to the ICU, in Japanese COVID-19 patients. Eosinopenia is associated with adverse outcomes after COVID-19 infection: A perspective from Japan. [Extracted from the article]

Background: Salmonella Typhi is highly prevalent in this part of the world and calls for research into accurately predicting the infection on the basis of various blood parameters while awaiting the blood culture reports. Materials & Methods: This cross sectional study was conducted in the Department of Internal Medicine, Hayatabad Medical Complex, Peshawar from 1st August, 2021 to 30 July, 2022. A total of 400 adult patients of either sex, between 18 to 70 years of age, with history of fever, and symptoms suggestive of typhoid fever for the past 07 days were included. The patients were categorized into cases and control groups on the basis of the blood culture reports. The stratification of the general variables against the eosinopenia and leukopenia was analyzed followed by further application of logistic regression to allow true estimation of the association. Results: The age distribution amongst the control and the cases group was 46.14±17.3SD and 47.03±16.7SD respectively. Leukopenia was observed statistically more (p value .000) in the cases as compared to the control group whereas no such statistically significant association was observed in case of eosinopenia. Further stratification with respect to age and gender didn't show any association in cases of eosinopenia and leukopenia. Logistic regression showed presence of leukopenia was seven times and eosinopenia was twice more in culture positive patients with culture positivity increase with unit increase in the leukopenia. Conclusion: In an appropriate clinical scenario, with history of ongoing fever for 1 week with associated unexplained gastrointestinal symptoms and evidence of leukopenia on the initial blood film, the diagnosis of typhoid fever is highly likely. [ABSTRACT FROM AUTHOR]

This study examined the distinctions between multisystem inflammatory syndrome associated with coronavirus disease 2019, Kawasaki disease, and infectious mononucleosis. These three inflammatory disorders have commonalities according to clinical and laboratory results, particularly in relation to eosinophil levels. In this retrospective, single-center study, we documented the examination records (acute phase reactants and complete blood count) and clinical and cardiological findings of 130 patients diagnosed with multisystem inflammatory syndrome, Kawasaki disease, and infectious mononucleosis. These patients were treated and received follow-up care in our hospital from March 12, 2020, to September 13, 2022, as per the hospital records. Statistical analyses were performed using NCSS 2007, version 1 software. Eosinopenia was more prevalent in children with multisystem inflammatory syndrome than in those with Kawasaki disease, who showed normal or elevated eosinophil counts. The eosinophil counts in patients with infectious mononucleosis typically fell within the normal range. Our study found no correlation between the eosinophil counts and cardiac involvement in pediatric patients with either condition. These findings indicate a higher prevalence of eosinopenia in patients with multisystem inflammatory syndrome, irrespective of cardiac involvement, than in those with Kawasaki disease. Despite similarities in clinical findings, Kawasaki disease and multisystem inflammatory syndrome in children necessitate further studies for distinct characteristic elucidation.

Background: Chronic spontaneous urticaria (CSU) is a chronic, sometimes debilitating skin disorder characterized by the appearance of wheals, angioedema, or both for a period of more than 6 weeks. Many biomarkers were explored for severity evaluation such as d dimer and C Reactive Protein. Objectives: The aim of the current study is to assess the usefulness of peripheral eosinopenia as a valuable and an applicable biomarker for CSU severity. Patients and methods: A case control study was conducted on 60 CSU patients. Patients were divided into 30 patients with mild UAS7 score <15 representing the controls and 30 patients with severe UAS7 score >28 representing the cases. Eosinophils count and other variables were compared. Results: Severe cases demonstrated significantly higher age (median 34 vs. 29 years, P =0.043), CRP (14 vs. 2 mg/L, P <0.001) and positive ASST (56.7% vs. 23.3%, P =0.008). In contrast, severe cases demonstrated significantly lower eosinophilic count (median 21 vs. 123 cell/mm³, P <0.001), basophilic count (median 5 vs. 25 cell/mm³, P <0.001), and total IgE (median 93 vs. 221.5 IU/ml, P <0.001). The eosinophilic count showed a significant-excellent AUC of 0.954. The best cutoff point was =70, at which sensitivity and specificity were 96.7% and 86.7%, respectively. Conclusion: Peripheral eosinophils are significantly lower count in severe urticarial patients (P value <0.001) and this could be used as a simple and accessible tool for monitoring urticaria activity. [ABSTRACT FROM AUTHOR]

Currently, the clinical factors affecting immune responses to influenza vaccines have not been systematically explored. The mechanism of low responsiveness to influenza vaccination (LRIV) is complicated and not thoroughly elucidated. Thus, we integrate our in‐house genome‐wide association studies (GWAS) analysis result of LRIV (N = 111, Ncase [Low Responders] = 34, Ncontrol [Responders] = 77) with the GWAS summary of 10 blood‐based biomarkers (sample size ranging from 62 076−108 794) deposited in BioBank Japan (BBJ) to comprehensively explore the shared genetics between LRIV and blood‐based biomarkers to investigate the causal relationships between blood‐based biomarkers and LRIV by Mendelian randomization (MR). The applications of four MR approaches (inverse‐variance‐weighted [IVW], weighted median, weighted mode, and generalized summary‐data‐based MR [GSMR]) suggested that the genetically instrumented LRIV was associated with decreased eosinophil count (β = −5.517 to −4.422, p = 0.004−0.039). Finally, we conclude that the low level of eosinophil count is a suggestive risk factor for LRIV. [ABSTRACT FROM AUTHOR]

During SARS-CoV-2 infection, eosinopenia may reflect a hyperactive immune response. In this study of hospitalized COVID-19 patients, we aimed to better understand the prognostic value of severe eosinopenia (absolute eosinophil count = 0 G/L) and decipher its underlying mechanisms. We retrospectively analyzed the records of COVID-19 patients hospitalized from March to June 2020 in three university hospitals in Marseille, France. We assessed the association between severe eosinopenia and a composite poor outcome in these patients, including the need for oxygen supplementation at >6 L/min, ICU admission, and in-hospital death. Among the 551 COVID-19 patients included in this study, severe eosinopenia was found in 228 (51%) of them on admission to hospital and was associated with a composite poor outcome using multivariate analysis (OR = 2.58; CI95 [1.77–3.75]; p < 0.0001). We found a significant association between the presence of severe eosinopenia on admission and the elevation in C-reactive protein, ferritin, IP-10, and suPAR. The histological findings in a series of 37 autopsies from patients who died from severe COVID-19 and presented with severe eosinopenia showed no pulmonary eosinophil trapping. Severe eosinopenia can be a reliable biomarker associated with a composite poor outcome in hospitalized COVID-19 adult patients. It may reflect the magnitude of immune hyperactivation during severe-to-critical COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: COVID 19 pandemic has given rise to several challenges to clinicians and one of the keys in this is to predict the set of patients who progress from mild disease to moderate and severe. Apart from the symptomatology and signs, there are several lab parameters varying from biochemical, hematological to radiological parameters which help us in stratifying the stage of disease and also in deciding on which set of patients need close and vigilant monitoring. This would help us in better stratification of disease and utilize the available infrastructure and resources in an optimum way for better management of the disease. Aim: To analyze the early warning efficiency of laboratory parameters individually or in combination in predicting the progress of disease in patients from mild to moderate/severe disease. Materials and Methods: This was taken up as a retrospective study with 100 cases and 100 controls. The demographic details, inflammatory markers, biochemical markers and hematological markers were analyzed. Test of significance was employed to compare categorical variables while student t-test was employed to test the difference in the mean value such as age between case and control (Mann–Whitney U-test in parameters not having normal distribution). Receiver operating characteristic (ROC) curve was constructed for these parameters using cases and controls and area under the curve (AUC) were estimated which was used as an indicator of sensitivity and specificity of the parameter in their early warning efficiency. The critical values for each of the parameters either individually or in combination was estimated as well. Results: Among the parameters C reactive protein (CRP), d-dimers and eosinopenia have the best early warning efficiency. The area under the ROCs curve for neutrophil lymphocyte ratio (NLR), CRP. Ferritin, lactate dehydrogenase, Eosinopenia was 0.609, 0.947, 0.614, 0.554, 0.617 respectively at triage. However, a combination of eosinopenia with CRP (AUC-0.732) or NLR with CRP (AUC-0.728) have a good sensitivity and specificity in predicting the outcome regarding the progression of the disease. Conclusions: Among the parameters, CRP, d-dimers, Eosinopenia and NLR have the best early warning efficiency. However, a combination of Eosinopenia and CRP at triage should also serve as a red flag sign in patients apart from the well-known NLR and IL6 values. [ABSTRACT FROM AUTHOR]

Yanxiong Mao,1,&ast; Yuanyuan Qian,2,&ast; Xiaoyan Sun,3 Na Li,1 Huaqiong Huang1 1Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Haining People’s Hospital, Haining Branch, The First Affiliated Hospital, Zhejiang University, Haining, Zhejiang, People’s Republic of China; 3Department of Gynecology, Women’s Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Huaqiong HuangKey Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of ChinaTel/Fax +86-571-87783552Email zr_hhq@zju.edu.cnBackground: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) could be triggered by community-acquired pneumonia (CAP). Peripheral blood eosinopenia are strongly associated with increased mortality. In hospitalized AECOPD patients with CAP, eosinopenia may be used to identify patients with high risk of death on admission.Methods: We conducted a retrospective cohort study in 82 hospitalized AECOPD patients with CAP. Patients who had received systemic corticosteroids preadmission were excluded. The patients were identified by individual case file review. According to blood eosinophil count, patients were grouped as eosinopenia (< 50/μL) and non-eosinopenia (≥ 50/μL). Association of eosinopenia with infection and 18-month survival were analyzed using appropriate statistical methods.Results: Baseline demographic, comorbidity, CURB65 and Pneumonia Severity Index scores were similar between two groups. The eosinopenia group had significantly higher pro-brain natriuretic peptide, D-dimer, neutrophil percentage, and lower lymphocyte count and lymphocyte percentage. The eosinopenia group had significantly higher C-reactive protein (median 77.30 vs 16.55, p=0.008) and procalcitonin (median 0.32 vs 0.12, p=0.001). Survival at 18 months after hospital discharge was significantly lower in the eosinopenia group vs non-eosinopenia group (log rank, p=0.002).Conclusion: Eosinopenia (< 50/μL) was a strong predictor of 18-month mortality and associated with more severe infection in hospitalized AECOPD patients with CAP. Eosinophil count at admission can be used as a prognosis marker of mortality in those population.Keywords: eosinopenia, chronic obstructive pulmonary disease, community-acquired pneumonia, mortality

Abstract Introduction Infection is one of the major causes of mortality and morbidity in older adults. Available biomarkers are not associated with prognosis in older patients. This study aimed to analyze the value of eosinopenia (eosinophil count

In December 2019, a new virus has been discovered, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to coronavirus disease 2019 (COVID-19). COVID-19 has been defined as an evolving disease with different phases. It starts with a mild or asymptomatic phase in which there is minimal disease. Thereafter, most patients recover, however, in 20% of the cases the infection worsens. It is hypothesized that eosinopenia, endothelial injury and the presence of smooth muscle autoantibodies are associated with the severity of the COVID-19. In a subset of 75 blood samples of patients with a SARS-CoV-2 infection at time of hospitalization and 30 healthy control samples concentrations of eosinophils, VEGF, VCAM, endothelin and smooth muscle autoantibodies were determined with hemocytometry, ELISA and immunofluorescence assays. In the group of patients with COVID-19 eosinophils (IQR = 0.0–0.01*109/L) were significantly decreased (p <.001), whereas markers of endothelial damage VCAM (IQR = 740–1120 ng/mL) and endothelin (IQR = 2.0–3.4 pg/mL) were significantly increased (p <.001) compared to the group of healthy controls (eosinophils IQR = 0.09–0.19*109/L, VCAM IQR = 362–561 ng/mL, endothelin IQR = 0.5–1.0 pg/mL). From the multivariate analysis, it is concluded that at time of hospitalization a combination of eosinopenia and increased markers of endothelial damage VCAM and endothelin are characteristic of COVID-19. [ABSTRACT FROM AUTHOR]

Background and Objectives: The triaging of COVID-19 patients is of paramount importance to plan further management. There are several clinical and laboratory parameters that help in categorizing the disease severity, triaging, and prognostication. Little is known about the prognostic significance of eosinopenia in predicting the severity of COVID-19 from large hospital data, especially from low- and middle-income countries. The objective of this study is to evaluate the level of eosinopenia as an early prognostic marker for assessing the outcomes in COVID-19 patients and to assess the superiority of eosinopenia as a prognostic marker for assessing the outcomes in COVID-19 patients compared to lymphopenia and neutrophil-to-lymphocyte ratio (NLR). Methods: The study was carried out in a tertiary care hospital. A retrospective longitudinal approach was adopted wherein the hospital records of COVID-19 patients were analyzed. In our study, two separate groups of patients were included for analysis to describe the association between initial eosinophil counts of the patients and the clinical outcomes. In the first group, the disease severity in terms of clinical and radiological parameters was compared in patients of COVID-19 presenting with and without the presence of initial eosinopenia. Commonly used markers for triage, namely lymphopenia and NLR, were compared with the presence of initial eosinopenia among the patients who progressed to moderate and severe disease. In the second group, an analysis of eosinopenia was made among the patients who succumbed to the illness. Results: It was seen that 29.6% of patients with eosinopenia had moderate and severe disease compared to those without eosinopenia where only 10.8% had moderate disease, none had severe disease. It was seen that 19.7% of patients with eosinopenia but no lymphopenia had more severe disease compared to patients with lymphopenia but no eosinopenia where 10.8% of the patients had moderate disease, none had severe disease. In patients younger than 60 years who died of COVID-19, it was found that initial eosinopenia was found in 86%, whereas a high NLR >17 was seen in only 25.6% of patients who died, thus implying that is eosinopenia is an important marker of disease severity in COVID-19. Conclusions: Eosinopenia is an important parameter in the evaluation of COVID-19 and the presence of it should alert the clinicians regarding the further progression of the disease. It is not only an important marker but also an early marker for severe disease. [ABSTRACT FROM AUTHOR]

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Amaç Covid-19 hastalığı, moleküler, serolojik veya radyolojik yöntemlerle teşhis edilir. Bununla birlikte, bu teşhis yöntemlerine her yerde ulaşılamaz veya sonuçlanması çok fazla zaman alabilir. Bu nedenle, Covid-19 hastalarının basit ve kolay erişilebilir laboratuvar biyobelirteçleri ile etkili teşhisine ihtiyacımız var. Bu nedenle Covid-19'da Eozinofilik Katyonik Proteinin (ECP) tanısal performansını araştırdık. Gereç ve yöntemler Çalışmamız geriye dönük bir vaka-kontrol çalışmasıdır. 15 Mart - 15 Haziran 2020 tarihleri arasında Covid-19 teşhisi konulan 30 hastanın kaydedilen klinik, laboratuvar ve radyolojik verileri uygun istatistiksel yöntemler kullanılarak 30 sağlıklı kişi ile karşılaştırıldı. Sonuçlar Hastalar ve kontroller sırasıyla ortalama yaşları 57,2 ± 15,46 ve 60,07 ± 20,59 olan 10 (% 33,3) kadın ve 20 (% 66,6) erkeklerdi. Hastaların başvuru sırasındaki eozinofil sayıları kontrollere göre anlamlı olarak düşüktü (p

Abstract Background Sepsis is a life-threatening and time-critical medical emergency; therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. However, its clinical application progress is slow and its recognition is low. Recent studies have again focused on the potential association between Eosinopenia and severe infections. This study analyzed the efficacy of Eosinopenia as a biomarker for diagnosis of sepsis and its correlation with pathophysiology of sepsis. Method The protocol for this meta-analysis is available in PROSPERO (CRD42020197664). We searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials CENTRAL databases to identify studies that met the inclusion criteria. Two authors performed data extraction independently. The pooled outcomes were calculated by TP (true positive), FP (false positive), FN (false negative), TN (true negative) by using bivariate meta-analysis model in STATA 14.0 software. Meanwhile, possible mechanisms of sepsis induced Eosinopenia was also analyzed. Results Seven studies were included in the present study with a total number of 3842 subjects. The incidence of Eosinopenia based on the enrolled studies varied from 23.2 to 92.7%. For diagnosis of sepsis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of Eosinopenia were 0.66 (95%CI [0.53–0.77]), 0.68 (95%CI [0.56–0.79]), 2.09 (95%CI [1.44–3.02]), 0.49 (95%CI [0.34–0.71]) and 4.23 (95%CI [2.15–8.31]), respectively. The area under the summary receiver operator characteristic curve (SROC) was 0.73 (95%CI [0.68–0.76]). Meta-regression analysis revealed that no single parameter accounted for the heterogeneity of pooled outcomes. For each subgroup of different eosinopenia cutoff values (50, 40, ≤25, 100), the sensitivity was 0.61, 0.79, 0.57, 0.54, and the specificity was 0.61, 0.75, 0.83, 0.51, respectively. Conclusions Our findings suggested that Eosinopenia has a high incidence in sepsis but has no superiority in comparison with conventional biomarkers for diagnosis of sepsis. However, eosinopenia can still be used in clinical diagnosis for sepsis as a simple, convenient, fast and inexpensive biomarker. Therefore, further large clinical trials are still needed to re-evaluate eosinopenia as a biomarker of sepsis.

Objectives: To analyse the diagnostic performance of eosinopenia, alone or combined with polymorphonuclear neutrophils (PMN) and/or lymphocytes, as a marker of active COVID-19 in patients hospitalized for suspicion of SARS-CoV-2 infection. Methods: A prospective observational study including patients hospitalized for suspicion of COVID-19 in a COVID unit was performed from 20th March to 5th April 2020, in Perpignan, France. Patients for which there was a doubt upon diagnosis, who were recently under oral corticosteroids, had myeloid malignancy or human immunodeficient virus infection were excluded. SARS-CoV-2 detection was performed using an RT-PCR assay, from nasopharyngeal swab specimens. Complete blood count were performed for all patients. Results: One-hundred and twenty-one patient were included: 57 patients were diagnosed with COVID-19, 64 patients were not. Eosinophil count was lower in the COVID-19 group (median: 0/μL versus 70/μL, p

The apicomplexan protozoans of the genera Hepatozoon and Babesia are emerging parasite pathogens most prevalent in canines in the Brazil. Although diagnostic definitive is based on molecular analysis, morphological findings and the quantitative hematological aspects are crucial for diagnosis and staging those parasitic diseases. Thus, we evaluated the hematological profile of canines naturally infected by Babesia spp. and Hepatozoon spp. through a retrospective study with 452 dogs diagnosed by blood smear. Clinical findings and population data were determined from the review of medical records. The hematological aspects of 124 dogs with Babesia spp. and 328 with Hepatozoon spp. young dogs, less than 1 year old and females were commonly affected by both diseases. In animals with Babesia spp., the most observed hematological alterations were anemia (83.87%), normocytic normochromic type (37.9%), leukopenia (45.16%), neutropenia (28.22%), lymphopenia (44.35%), eosinopenia (71.77%), monocytopenia (29.03%), and thrombocytopenia (86.03%). In animals infected with Hepatozoon spp. were anemia (76.52%), normocytic normochromic type (49.69%), leukocytosis (26.22%), neutrophilia (30.49%), lymphopenia (29.57%), eosinopenia (40.55%), monocytopenia (21.04%), and thrombocytopenia (54.27%). This study highlights the importance of epidemiological care, especially with the puppies, keeping them free from disease vectors and reinforces the importance of the blood count in the diagnosis, treatment, and prognosis of these diseases. [ABSTRACT FROM AUTHOR]

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Copyright of Romanian Journal of Veterinary Medicine & Pharmacology is the property of Innovation in Health Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Eosinopenia has been described in COVID-19. With this study, we aim to study the peripheral blood eosinophil counts in COVID-19 patients and to investigate whether there is an association between the peripheral blood eosinophil counts and disease severity of COVID-19. Methods: We revised the electronical medical records of confirmed COVID-19 patients with polymerase chain reaction (PCR) assays in the Groene Hart Ziekenhuis, Gouda, The Netherlands. We divided patients in mild, moderate and severe groups based on clinical severity of COVID-19. Clinical severity was based on the therapy needed and the outcome of patients. We compared clinical characteristics, laboratory results and outcome between the three groups. Results: Of the 230 patients included in this study, the mild, moderate and severe groups consisted of 16.5%, 45.7% and 37.8% of the included patients, respectively. The mean age was 68 years (IQR 57–78). 63% of patients were male. A significant decrease in the peripheral eosinophil counts was found corresponding to the increase of COVID-19 severity. In the mild, moderate and severe groups, the percentage of patients with eosinopenia was 73.7%, 86.7% and 94.3%, respectively (p value 0.002). Conclusion: Eosinopenia is significantly more frequent present in patients with a severe COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Infection is one of the major causes of mortality and morbidity in older adults. Available biomarkers are not associated with prognosis in older patients. This study aimed to analyze the value of eosinopenia (eosinophil count< 100/mm3) as a prognosis marker among older patients with suspected or confirmed bacterial infection.Methods: A retrospective study was performed from 1 January to 31 December 2018 among patients in a geriatrics ward suffering from a bacterial infection treated with antibiotics. Biomarker data including the eosinophil count, neutrophil count and C-reactive protein (CRP) were collected within 4 days after patient diagnosis. Persistent eosinopenia was defined as a consistent eosinophil count< 100/mm3 between Day 2 and Day 4. The association of biomarkers with 30-day hospital mortality in a multivariate analysis was assessed and their predictive ability using the area under the ROC curve (AUC) was compared.Results: Our study included 197 patients with a mean age of 90 ± 6 years. A total of 36 patients (18%) died during their stay in hospital. The patients who died were more likely to have persistent eosinopenia in comparison to survivors (78% versus 34%, p < 0.001). In the multivariate analysis, persistent eosinopenia was associated with in-hospital mortality with an adjusted HR of 8.90 (95%CI 3.46-22.9). The AUC for eosinophil count, CRP and neutrophil count between Day 2 and Day 4 were 0.7650, 0.7130, and 0.698, respectively.Conclusion: Persistent eosinopenia within 4 days of diagnosis of bacterial infection appeared to be a predictor of in-hospital mortality in older patients. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic that has affected over two hundred countries and led to the increasing challenge of identifying, diagnosing, and treating patients. An effective early diagnostic marker is necessary for the identification of affected individuals, which would further aid in helping the prognosis. Objective: The aim was to study the diagnostic role of the eosinophil count in COVID-19 infection. Methodology: Thirty-five COVID-19 cases, confirmed either by RT-PCR or HRCT (high-resolution CT scan) were included in this cross-sectional study. Results: Out of the 35 patients, 26 (74.3%) had an eosinophil count of 0, six (17.1%) had a count of 1–2 eosinophils, and one had a count of 4. Conclusion: The absence of eosinophils in the routine complete blood count examination may certainly help in the early identification of a COVID-19 infection. Early identification may help in early therapeutic management and hence prevent further deterioration of the patient’s health. [ABSTRACT FROM AUTHOR]