Blood eosinophilia as a susceptibility biomarker for incident respiratory disease in hospitalized adults: a retrospective cohort study.
9 affiliations
- 1Department of Respiratory Diseases, CHU Montpellier, Arnaud de Villeneuve Hospital, Montpellier, 34000, France.
- 2PhyMedExp INSERM 1046, UMR UM, CNRS 9214, University of Montpellier, Montpellier, 34000, France.
- 3Clinical Research and Epidemiology Unit (Public Health Department), CHU Montpellier, Univ Montpellier, Montpellier Cedex 5, France.
- 4Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, Etablissement Français du Sang, Montpellier, France.
- 5Department of Virology, Montpellier University Hospital, Montpellier, France.
- 6Institut Desbrest d'Épidémiologie et de Santé Publique, Univ Montpellier- INSERM - INRIA PreMediCal, Montpellier, France.
- 7Division of Medical Information, La Colombiere University Hospital of Montpellier, Montpellier, France.
- 8Department of Respiratory Diseases, CHU Montpellier, Arnaud de Villeneuve Hospital, Montpellier, 34000, France. [email protected].
- 9PhyMedExp INSERM 1046, UMR UM, CNRS 9214, University of Montpellier, Montpellier, 34000, France. [email protected].
Abstract
Background
Circulating eosinophils can be measured inexpensively and reproducibly in routine care. Beyond their role in parasite defense and allergy, blood eosinophilia is now a key biomarker in respiratory medicine: prognostic, predictive, and recognized as a "treatable trait." Its role as a marker of susceptibility, however, is not well defined.Methods
We conducted a monocentric retrospective hospital-based cohort study at Montpellier University Hospital (France), including all adults hospitalized in 2018 with a complete blood count and without prior respiratory disease. Eosinophil counts were stratified as < 150/mm³, 150-299/mm³, and ≥ 300/mm³. The primary outcome was incident respiratory disease, defined by hospitalization with a respiratory diagnosis (ICD-10 J00-J99) or initiation of inhaled therapy (ATC R03). Follow-up extended to December 2024; secondary outcomes included diagnostic subcategories and ICU admission.Results
Among 24,405 patients, 6,173 (25.3%) developed incident respiratory disease. Event rates followed a dose-response pattern across eosinophil strata: 21.7% (< 150/mm³), 26.0% (150-299/mm³), and 32.9% (≥ 300/mm³; p < 0.001 pairwise comparisons across all groups). After multivariable adjustment, eosinophilia remained independently associated with higher risk of developing respiratory disease (HR 1.45, 95% CI 1.35-1.55). Baseline eosinophilia was also associated to increased ICU admissions and greater disease severity during the follow-up.Conclusion
Blood eosinophilia was strongly associated with both increased risk of developing incident respiratory disease and in-hospital severity, in a clear dose-response manner. However, most patients with high counts (> 300/mm3) did not develop respiratory events, underscoring the need to integrate blood eosinophil counts with complementary clinical and biological data for risk stratification.
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BibTeX
@article{roure2026blood,
title = {{Blood eosinophilia as a susceptibility biomarker for incident respiratory disease in hospitalized adults: a retrospective cohort study.}},
author = {Charles Roure and Jeremy Charriot and Dany Jaffuel and Erika Nogue and Manal Ahikki and Edouard Tuaillon and Nicolas Molinari and Arnaud Bourdin and Engi Ahmed},
journal = {Respiratory research},
year = {2026},
month = aug,
doi = {10.1186/s12931-026-03851-8},
url = {https://europepmc.org/article/MED/42958569},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Blood eosinophilia as a susceptibility biomarker for incident respiratory disease in hospitalized adults: a retrospective cohort study.
AU - Charles Roure
AU - Jeremy Charriot
AU - Dany Jaffuel
AU - Erika Nogue
AU - Manal Ahikki
AU - Edouard Tuaillon
AU - Nicolas Molinari
AU - Arnaud Bourdin
AU - Engi Ahmed
PY - 2026
DA - 2026/08/04
JO - Respiratory research
DO - 10.1186/s12931-026-03851-8
UR - https://europepmc.org/article/MED/42958569
AB - Background Circulating eosinophils can be measured inexpensively and reproducibly in routine care. Beyond their role in parasite defense and allergy, blood eosinophilia is now a key biomarker in respiratory medicine: prognostic, predictive, and recognized as a "treatable trait." Its role as a marker of susceptibility, however, is not well defined.Methods We conducted a monocentric retrospective hospital-based cohort study at Montpellier University Hospital (France), including all adults hospitalized in 2018 with a complete blood count and without prior respiratory disease. Eosinophil counts were stratified as < 150/mm³, 150-299/mm³, and ≥ 300/mm³. The primary outcome was incident respiratory disease, defined by hospitalization with a respiratory diagnosis (ICD-10 J00-J99) or initiation of inhaled therapy (ATC R03). Follow-up extended to December 2024; secondary outcomes included diagnostic subcategories and ICU admission.Results Among 24,405 patients, 6,173 (25.3%) developed incident respiratory disease. Event rates followed a dose-response pattern across eosinophil strata: 21.7% (< 150/mm³), 26.0% (150-299/mm³), and 32.9% (≥ 300/mm³; p < 0.001 pairwise comparisons across all groups). After multivariable adjustment, eosinophilia remained independently associated with higher risk of developing respiratory disease (HR 1.45, 95% CI 1.35-1.55). Baseline eosinophilia was also associated to increased ICU admissions and greater disease severity during the follow-up.Conclusion Blood eosinophilia was strongly associated with both increased risk of developing incident respiratory disease and in-hospital severity, in a clear dose-response manner. However, most patients with high counts (> 300/mm3) did not develop respiratory events, underscoring the need to integrate blood eosinophil counts with complementary clinical and biological data for risk stratification.
SN - 1465-9921
SN - 1465-993X
ER -