Blood eosinophilia as a susceptibility biomarker for incident respiratory disease in hospitalized adults: a retrospective cohort study.

Authors

Charles Roure, Jeremy Charriot, Dany Jaffuel, Erika Nogue, Manal Ahikki, Edouard Tuaillon, Nicolas Molinari, Arnaud Bourdin, Engi Ahmed

Published in

Respiratory research. Volume 27. Issue 1. Aug 04, 2026. Epub Aug 04, 2026.

Abstract

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.
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.
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.
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.

PMID:
42958569
Bibliographic data and abstract were imported from PubMed on 30 Oct 2026.

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