The role of blood eosinophil level in acute exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) has great implications on global health accounting for significant morbidity and mortality. The aim of this study was to assess blood eosinophil level in patients presenting with acute exacerbation of COPD and to check whether pre-treatment blood eosinophil level ≥2% has better improvement with the standard therapy (oxygen, corticosteroids IV/ Oral and inhaled corticosteroids/ inhaled beta 2 agonist/ inhaled muscarinic antagonists along with antibiotics and diuretics) as well as shorten the duration of hospital stay.

Methods: Blood eosinophil level was measured in 106 eligible patients on admission with the diagnosis of AECOPD, under the Department of Pulmonology and Critical Care Medicine, TUTH from December 2016 to August 2017 were included in this observational study. Clinical information was obtained and PFTs were done.

Results: A total 106 patients were enrolled. The mean age of the patients was 67±12 years with smoking history of mean pack year 24± 10.7. Among this population, 46.22% patients had blood eosinophil level ≥2% which had better improvement in general physical examination (edema and cyanosis/ P= 0.05 and 0.01), vital signs (tachycardia P=0.05) including (SPO2 P=0.01) and chest findings (crackles P= 0.01) with standard therapy compared to blood eosinophil level <2%. Similarly, significant shorter duration of hospital stay was observed in patients with blood eosinophil level ≥2% with standard therapy in comparison with blood eosinophil <2% (p=0.01).

Conclusion: Blood eosinophil level represents a potentially important biomarker that could aid treatment decision making as well as gives us a predictive idea regarding the duration of hospital stay upon admission with AECOPD.