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Eosinophilic phenotype was associated with better clinical remission in elderly but not middle-aged patients with acute exacerbations of COPD
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  • Qianglin Zeng,
  • Hao Wang,
  • Tao Wang,
  • Ke Wang,
  • Hui Zhou,
  • Fuqiang Wen
Qianglin Zeng
West China Hospital of Sichuan University
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Hao Wang
West China Hospital of Sichuan University
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Tao Wang
West China Hospital of Sichuan University
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Ke Wang
West China Hospital of Sichuan University
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Hui Zhou
Affiliated Hospital & Clinical College of Chengdu University
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Fuqiang Wen
West China Hospital of Sichuan University
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Abstract

Background: There is limited evidence of the relationship between peripheral blood eosinophilia and clinical remission of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at different ages, especially in elderly patients, which was the objective of the present study. Methods: This retrospective study stratified patients by age (>65 or ≤65 years) and analyzed the relationship between blood eosinophilia (≥2% or <2%) and AECOPD clinical remission at observing time points of 7, 10, 14, 21, and 28 days. Results: Of 703 AECOPD cases analyzed, 616 were elderly (>65 years), 272 of whom had eosinophilic exacerbations. There were statistically significant differences in leukocyte count, high-sensitivity C-reactive protein levels (hs-CRP), and overall and daily hospital costs between eosinophilic and non-eosinophilic AECOPD patients (p<0.05, respectively). In the overall analysis, eosinophilic exacerbation was significantly associated with a higher remission rate at 7 (hazard ratio [HR]=1.457 [1.072, 1.982]), 10 (HR=1.316 [1.108, 1.562]), 14 (HR=1.334 [1.102, 1.615]), 21 (HR=1.326 [1.125, 1.562]), and 28 days (HR=1.254[1.078, 1.459]). The subgroup analysis showed that eosinophilic exacerbation yielded better clinical remission than non-eosinophilic exacerbation in elderly patients (>65 years old) at 7 (HR=1.521 [1.084, 2.136]), 10 (HR=1.319 [1.096, 1.588]), 14 (HR=1.374 [1.118, 1.689]), 21 (HR=1.326 [1.112, 1.582]), and 28 days (HR=1.234 [1.049, 1.451]), while no differences were observed in middle-aged patients (between 45 and 65 years) at all time points (all p>0.05). Conclusion: The eosinophilic phenotype was associated with better clinical remission at 7, 10, 14, 21, and 28 days among elderly but not in middle-aged patients with AECOPD.

Peer review status:ACCEPTED

11 Nov 2020Submitted to International Journal of Clinical Practice
12 Nov 2020Submission Checks Completed
12 Nov 2020Assigned to Editor
16 Nov 2020Reviewer(s) Assigned
14 Dec 2020Review(s) Completed, Editorial Evaluation Pending
26 Feb 20211st Revision Received
26 Feb 2021Assigned to Editor
26 Feb 2021Submission Checks Completed
10 Apr 2021Reviewer(s) Assigned
15 Apr 2021Review(s) Completed, Editorial Evaluation Pending
01 May 20212nd Revision Received
05 May 2021Submission Checks Completed
05 May 2021Assigned to Editor
05 May 2021Review(s) Completed, Editorial Evaluation Pending
09 May 2021Reviewer(s) Assigned
24 May 2021Editorial Decision: Accept