PT  - JOURNAL ARTICLE
AU  - Signe Vedel-Krogh
AU  - Børge G. Nordestgaard
AU  - Peter Lange
AU  - Jørgen Vestbo
AU  - Sune F. Nielsen
TI  - Blood eosinophil count and risk of pneumonia hospitalisations in individuals with COPD
AID  - 10.1183/13993003.00120-2018
DP  - 2018 Jan 01
TA  - European Respiratory Journal
PG  - 1800120
4099  - http://erj.ersjournals.com/content/early/2018/04/05/13993003.00120-2018.short
4100  - http://erj.ersjournals.com/content/early/2018/04/05/13993003.00120-2018.full
AB  - Introduction: Blood eosinophil count in COPD is associated with higher exacerbation rate and favorable response to corticosteroids; however, frequent exacerbations and use of inhaled corticosteroids could also elevate pneumonia risk. We tested the hypothesis that high blood eosinophil counts are associated with high risk of pneumonia in individuals with severe COPD from the general population.Methods: We included 7,180 individuals with COPD, including 643 with FEV1<50% of the predicted value from the Copenhagen General Population Study, from 2003-2011. All primary discharge diagnoses of pneumonia during follow-up were recorded.Results: Among individuals with COPD and FEV1<50% of the predicted value, the multivariable adjusted incidence rate ratio was 2.17(95% confidence interval, 1.31–3.58) for pneumonia comparing individuals with blood eosinophil counts at or above versus below 0.34·109/L. In individuals with clinical COPD, defined by recent exacerbation, ≥10 pack-years, and FEV1<70% of the predicted value, the corresponding risk was 4.52(2.11–9.72). Risk of pneumonia did not differ by blood eosinophil count in individuals with COPD and FEV1≥50% of the predicted value.Conclusion: In individuals with COPD and FEV1 below 50% percent of predicted value, blood eosinophil count of 0.34·109/L or higher was associated with high risk of hospitalisation due to pneumonia.Eosinophilic COPD with severely impaired lung function is associated with high risk of pneumonia hospitalizationsFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Vedel-krogh has nothing to disclose.Conflict of interest: Dr. Nordestgaard has nothing to disclose.Conflict of interest: Dr. Vestbo reports personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi Pharmaceuticals, personal fees from GlaxoSmithKline, personal fees from Novartis, outside the submitted work; .Conflict of interest: Dr. Nielsen has nothing to disclose.Conflict of interest: Dr. Lange reports grants and personal fees from Almirall, grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Novartis, personal fees from Norpharma, personal fees from Takeda, grants and personal fees from GlaxoSmithKline, personal fees from Pfizer, outside the submitted work; .