Tuberc Respir Dis > Accepted Articles
DOI:    [Accepted]
Published online May 3, 2024.
Eosinophilia is a favorable marker for pneumonia in chronic obstructive pulmonary disease
Kang-Mo Gu1  , Jae-Woo Jung1  , Min-Jong Kang2  , Deog Kyeom Kim3  , Hayoung Choi4  , Young-Jae Cho5  , Seung Hun Jang6  , Chang-Hoon Lee7  , Yeon Mok Oh8  , Ji Sook Park9  , Jae Yeol Kim1 
1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
2Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America, 06520-8057
3Department of Internal Medicine, Seoul National University College of Medicine, SMG-SNU Borame Medical Center, Seoul, Republic of Korea
4Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
6Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
7Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
8Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
9Department of Software Convergence, Seoul Women's University College of Interdisciplinary Studies for Emerging Industries, Seoul, Republic of Korea
Correspondence:  Jae Yeol Kim, Tel: +82-01-3173-7839, Fax: +82-2-825-7571, 
Received: 27 October 2023   • Revised: 10 January 2024   • Accepted: 29 April 2024
Patients with chronic obstructive pulmonary disease (COPD) expressing eosinophilia experience slightly fewer episodes of community-acquired pneumonia (CAP) than those without eosinophilia. However, the severity and burden of hospitalized pneumonia patients with COPD concerning eosinophilia have not been assessed.
We evaluated the differences in clinical characteristics between patients with CAP and COPD with or without eosinophilia by a post-hoc analysis of a prospective, multi-center, cohort study data.
Of 349 CAP patients with COPD, 45 (12.9%) had eosinophilia (blood eosinophil ≥ 300 cells/µL). Patients with eosinophilia had a lower sputum culture percentile (8.1% vs. 23.4%, P < 0.05), a lower percentile of neutrophils (70.3% vs 80.2%, P<0.05), reduced C-reactive protein levels (30.6 mg/L vs 86.6 mg/L, P<0.05), and a lower pneumonia severity index score (82.5 vs. 90.0, P < 0.05) than those without eosinophilia. The duration of antibiotic treatment (8.0 days vs. 10.0 days, P < 0.05) and hospitalization (7.0 days vs. 9.0 days, P < 0.05) were shorter in eosinophilic patients. The cost of medical care per day (256.4 US$ vs. 291.0 US$, P < 0.05), cost for the medication (276.4 US$ vs. 349.9 US$, P < 0.05), and cost for examination (685.5 US$ vs 958.1 US$, P<0.05) were lower in patients with eosinophilia than those without eosinophilia.
Eosinophilia serves as a favorable marker for severity of pneumonia, health-care consumption, and cost of medical care in patients with CAP and COPD.
Key Words: COPD, pneumonia, eosinophilia, severity, cost

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