ASSOCIATION BETWEEN EOSINOPHIL LEVEL AND PREDICTION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXACERBATION

Abstract

Background:Chronic obstructive pulmonary disease (COPD) is a common treatable and preventable
diseasecharacterized by progressive airflow limitation with an enhanced chronic inflammatory
response in the airways.Acute exacerbation of COPD is associated with substantial morbidity and
mortality.This study aimed to predict the outcome and future risk of COPD exacerbations and to
improve the health quality of COPD patients.Patients and methods: A Cohort prospective study was
designed to investigate thirty four hospitalized COPD patients with COPD exacerbation whether in the
ward or in the ICU and follow up them for 12 months.Results:Outcome of the exacerbation at
admission among the studied patients; 32.4% of had sputum eosinophilia and most of them (76.5%)
received LABA as treatment before admission. There was no statistically significant association
between eosinophils level at admission and the outcome among the studied group where one patient
(9.1%) died among patients with eosinophilia≥2% and also one patient (4.3%) died among patients
with eosinophils<2%.Only (31.25%) of the survived patients had sputum eosinophilia(>1.25%), half of
them (50.0%) had future single exacerbation, about one third (34.4%) had two exacerbations and
(15.6%) had no further exacerbations. all of them (100.0%)received LABA, LAMA and ICS as a triple
therapy. There was statistically significant higher TLC, neutrophil count and longer hospital stay
among patients with eosinophils<2% than patients with eosinophils ≥2%. But regarding degree of
exacerbation, management and outcome, there was no statistically significant difference between
patients with low and high eosinophilia. Conclusion:High neutrophil level in peripheral blood
duringfollow up period of COPD patients, besides low eosinophil level in both blood and sputum are
considered predictor factors for future COPD exacerbations.