Pneumologie 2025; 79(S 01): S92-S93
DOI: 10.1055/s-0045-1804746
Abstracts
D1 – Infektiologie und Tuberkulose

Eosinophil count as biomarker for risk stratification of community-acquired pneumonia: a prospective cohort study

B Weckler
1   Philipps-University Marburg; Department of Medicine, Pulmonary and Critical Care Medicine; Clinic for Airway Infections
,
R Martin
2   University of Marburg; Department of Mathematics and Computer Science; Data Science in Biomedicine
,
M Kutzinski
1   Philipps-University Marburg; Department of Medicine, Pulmonary and Critical Care Medicine; Clinic for Airway Infections
,
W Bertrams
3   Philipps Universität Marburg; Ilung – Institute for Lung Research
,
A Jung
4   Institute for Lung Research, Universities of Giessen and Marburg Lung Center, German Center for Lung Research (Dzl), Philipps-University Marburg; Core Facility Flow Cytometry – Bacterial Vesicles, Philipps-University Marburg
,
H Pott
5   Department of Medicine, Pulmonary and Critical Care Medicine, Clinic for Airway Infections, University Medical Centre Marburg, Philipps-University Marburg; University Medical Centre Marburg; Clinic for Airway Infections
,
K Laakmann
6   Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Philipps-University Marburg, German Center for Lung Research (Dzl), Marburg, Germany; Institute for Lung Research
,
L Schulte
7   Philipps-Universität Marburg; Institute for Lung Research, Universities of Giessen and Marburg Lung Center (Ugmlc)
,
P Ahnert
8   Universität Leipzig; Mediziniche Fakultät; Institut für Medizinische Informatik, Statistik und Epidemiologie
,
D Heider
9   University of Marburg; Data Science in Biomedicine, Department of Mathematics and Computer Science; Department of Mathematics and Computer Science
,
S Ringshandl
10   Philipps-University Marburg; Department of Medicine; Data Integration Centre (Dic)
,
C Seidemann
10   Philipps-University Marburg; Department of Medicine; Data Integration Centre (Dic)
,
N Suttorp
11   Med. Klinik M. S. Infektiologie Und Pneumologie; Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin
,
M Witzenrath
12   Charité-Universitätsmedizin Berlin; Klinik für Pneumologie, Beatmungsmedizin und Intensivmedizin M.D.A. Schlafmedizin
,
J Wildberg
13   Charité-Universitätsmedizin Berlin; Department of Infectious Diseases, Respiratory Medicine and Critical Care
,
M Lehmann
14   Helmholtz-Zentrum München; Institute for Lung Research, Universities of Giessen and Marburg Lung Center (Ugmlc), Philipps-Universität Marburg
,
G Rohde
15   Goethe University Frankfurt; University Hospital, Medical Clinic I; Department of Respiratory Medicine
,
T Greulich
16   Universitätsklinikum Marburg; Klinik für Innere Medizin, Schwerpunkt Pneumologie
,
C Vogelmeier
17   Phillips-Universität Marburg; Department of Medicine, Pulmonary, and Critical Care Medicine
,
B Schmeck
18   Klinik für Innere Medizin M.S. Pneumologie, Philipps-Universität Marburg, Deutsches Zentrum für Lungenforschung (Dzl); Institute for Lung Research, Universities of Giessen and Marburg Lung Center, German Center for Lung Research (Dzl), Marburg, Germany
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Background: Retrospective evidence suggests that eosinopenia is associated with worse outcomes in patients with community-acquired pneumonia (CAP). However, data about the relationship between blood eosinophil levels and well-established risk stratification scores for CAP are missing, and a suitable eosinophil count threshold for distinguishing high- from low-risk patients has not been determined yet. This study therefore investigated blood eosinophil count at hospital admission as a biomarker for risk stratification of CAP.

Methods: Adult patients were recruited in a prospective observational multi-centre study on hospitalised CAP (PROGRESS). The correlation between blood eosinophil numbers at hospital admission as continuous variable and risk stratification scores was analysed. A continuous analysis of eosinophil numbers versus mortality and risk of mechanical ventilation was performed for threshold determination of eosinopenia as a biomarker for risk stratification. Based on this analysis, patients were allocated to an eosinopenia (≤ 50/µL) and non-eosinopenia (> 50/µL) group. Their baseline characteristics and outcomes were compared.

Findings: Overall, 1763 (60.0% males, median age 63.0 years) patients were included. Eosinophil counts correlated inversely with CRB-65 (p<0·0001), CURB-65 (p<0·0001), PSI (p<0·0001), Infectious Disease Society of America/American Thoracic Society minor criteria (p<0·0001), SOFA (p<0·0001), and Quick SOFA (p=0·0155). An eosinophil count threshold of 50/µL was proven suitable for risk stratification: Eosinopenia (versus non-eosinopenia) was associated with increased in-hospital mortality (2·8% versus 1·2%; RR 2·29; p=0·0251), need for mechanical ventilation (14·7% versus 7·1%; RR 2·07; p<0·0001), and length of stay (8 versus 7 days; p=0·0048). After compensating for multiple confounders including glucocorticoid treatment in the multivariate analysis, eosinopenia≤50/µL (versus non-eosinopenia) correlated with an increased (p=0·0003) need for mechanical ventilation.

Interpretation: In a prospective multicentre study, blood eosinophil count at hospital admission correlates with well-established risk stratification scores for CAP. Eosinopenia≤50/µL seems to be a promising biomarker for risk stratification.



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Artikel online veröffentlicht:
18. März 2025

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