ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1525709
This article is part of the Research TopicEosinophilic Inflammation in Chronic Lung Diseases: Emerging Molecular Insights and Therapeutic StrategyView all 6 articles
Association between eosinophil count and prognosis in chronic obstructive pulmonary disease patients
Provisionally accepted
- 1Chi Mei Medical Center, Tainan, Taiwan
- 2Chi Mei Medical Center, Chiali, Tainan, Taiwan
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Background: The association between blood eosinophil levels and the risk of increased exacerbations, acute respiratory failure (ARF) and mortality in chronic obstructive pulmonary diseases (COPD) remains controversial. This association may predict future exacerbations and clinical outcomes among patients with COPD. This study aimed to clarify the relationship between eosinophil count and risk of acute exacerbation, ARF and mortality s in patients with COPD. Methods: The data for this retrospective cohort study were collected from TriNetX, a global multicentre research database. Using the Global Collaborative Research Networks, patients aged > 40 years with a diagnosis of COPD were examined for the association between blood eosinophil counts and the risk of acute exacerbation during a 3-year follow-up period. Cox proportional hazard models and Kaplan–Meier analysis were used to assess the risk of acute exacerbation between the non-eosinophilic (blood eosinophil counts <300 cells/μL) and eosinophilic groups (≥300 cells/μL) after propensity score matching. Other outcomes including survival and ARF, were also examined. Results: The non-eosinophilic group had a 1.27-fold lower risk of acute exacerbations of COPD (hazard ratio [HR], 0.790; 95% confidence interval [95% CI], 0.74–0.85; p < 0.001), a 1.22-fold lower risk of all-cause mortality (HR, 0.818; 95% CI, 0.76–0.88; p < 0.001) and a 1.39-fold lower risk of ARF (HR, 0.721; 95% CI, 0.66–0.78; p < 0.001) compared to the eosinophilic group during the 3-year follow-up period. Conclusion: Increased eosinophil count may be linked to an elevated risk of exacerbation, respiratory failure, and mortality in COPD.
Keywords: eosinophils, COPD, acute exacerbation, acute respiratory failure Abbreviations: CI: confidence interval, CKD: Chronic kidney disease, COPD: chronic obstructive pulmonary disease, ED: emergency department, FEV1: forced expiratory volume in 1 second, HR: hazard ratios, ICS: inhaled corticosteroid, MV: Mechanical Ventilation
Received: 10 Nov 2024; Accepted: 18 Aug 2025.
Copyright: © 2025 Hsu, Shiau, Lai and Liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kuang-Ming Liao, Chi Mei Medical Center, Chiali, Tainan, Taiwan
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