Clinical Characteristics and 2-Year Outcomes of Chronic Obstructive Pulmonary Disease Patients With High Blood Eosinophil Counts: A Population-based Prospective Cohort Study in China

• Xiaohui Wu ^[1] ; Zhishan Deng ^[1] ; Fan Wu ^[1] ; Youlan Zheng ^[1] ; Peiyu Huang ^[1] ; Huajing Yang ^[1] ; Ningning Zhao ^[1] ; Cuiqiong Dai ^[1] ; Jieqi Peng ^[1] ; Lifei Lu ^[1] ; Kunning Zhou ^[1] ; Qi Wan ^[1] ; Gaoying Tang ^[1] ; Shengtang Chen ^[2] ; Yongqing Huang ^[3] ; Changli Yang ^[2] ; Shuqing Yu ^[3] ; Pixin Ran ^[1] ; Yumin Zhou ^[1]
  1. [1] National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
  2. [2] Wengyuan County People's Hospital, Shaoguan, China
  3. [3] Lianping County People's Hospital, Heyuan, China

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 60, Nº. 7, 2024, págs. 402-409
• Idioma: inglés
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• Resumen

  • Background High blood eosinophil count (BEC) is a useful biomarker for guiding inhaled corticosteroid therapy in patients with chronic obstructive pulmonary disease (COPD), yet its implications in a community setting remain underexplored. This study aimed to elucidate the clinical characteristics and outcomes of COPD patients with high BEC within the Chinese community.

    Methods We obtained baseline and 2-year follow-up data from COPD patients (post-bronchodilator forced expiratory volume in 1 second/forced vital capacity <0.70) in the early COPD study. Patients with a BEC ≥300cells/μL were classified as the high BEC group. We assessed differences in the clinical characteristics and outcomes between high and low BEC patients. Subgroup analyses were conducted on COPD patients without a history of corticosteroid use or asthma.

    Results Of the 897 COPD patients, 205 (22.9%) had high BEC. At baseline, high BEC patients exhibited a higher proportion of chronic respiratory symptoms, lower lung function, and more severe small airway dysfunction than low BEC patients. Over the 2-year period, high BEC patients experienced a significantly higher risk of acute exacerbations (relative risk: 1.28, 95% confidence interval: 1.09–1.49; P=0.002), even after adjusting for confounders. No significant difference was observed in lung function decline rates. The subgroup analysis yielded consistent results.

    Conclusions COPD patients with high BEC in a Chinese community exhibited poorer health status, more severe small airway dysfunction, and a higher risk of exacerbations. Future research should explore the pathological mechanisms underlying the poorer prognosis in patients with high BEC.