Eosinopenia as Predictor of Poor Outcome in Hospitalized COVID-19 Adult Patients from Waves 1 and 2 of 2020 Pandemic

Raphael Cauchois (1) , Lea Pietri , Jean-Baptiste Dalmas (2) , Marie Koubi (1, 3) , Thibaut Capron (4) , Nadim Cassir (5, 6) , Nicola Potere , Ildo Polidoro , Rodolphe Jean (7) , Pierre-André Jarrot (1) , Baptiste Andre , Veronique Veit (3) , Julien Carvelli , Vanessa Pauly (8) , Pascal Chanez (1) , Laurent Papazian (9) , Gilles Kaplanski (1)

1 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
2 AMU SMPM MED - Aix-Marseille Université - École de médecine
3 APHM - Assistance Publique - Hôpitaux de Marseille
4 CRMBM - Centre de résonance magnétique biologique et médicale
5 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
6 MEPHI - Microbes évolution phylogénie et infections
7 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
8 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
9 Hôpital Nord [CHU - APHM]

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.

Mots clés: eosinopenia; COVID-19; prognosis; biomarker

Domaines: Sciences du Vivant [q-bio]

Raphael Cauchois, Lea Pietri, Jean-Baptiste Dalmas, Marie Koubi, Thibaut Capron, et al.. Eosinopenia as Predictor of Poor Outcome in Hospitalized COVID-19 Adult Patients from Waves 1 and 2 of 2020 Pandemic. Microorganisms, 2022, 10 (12), pp.2423. ⟨10.3390/microorganisms10122423⟩. ⟨hal-03959909⟩