• Rong Huang, Liangcai Xie, Junpeng He, Hong Dong, and Tianchun Liu.
• Department of Laboratory Medicine, Jingzhou First People's Hospital, Jingzhou, Hubei Province, China.
• Medicine (Baltimore). 2021 Jun 11; 100 (23): e26047e26047.

BackgroundThe conclusions about the relationship between eosinophil counts and the severity of coronavirus disease 2019 (COVID-19) were controversial, so we updated the evidences and reassessed it.MethodsWe searched the PubMed, Cochrane library, Excerpta Medica Database, and Web of Science to compare the eosinophil counts about non-severe disease group (mild pneumonia, moderate pneumonia, non-critical disease and recovery group) and severe disease group (severe pneumonia, critical pneumonia, critical disease and death group) in COVID-19.ResultsA total of 1228 patients from 10 studies were included. Compared with non-severe group, severe group had strikingly lower average eosinophil counts (SMD 0.65, 95% confidence intervals [CI] 0.29-1.01; P < .001). The result of subgroup analysis of different countries showed SMD 0.66, 95% CI 0.26-1.06; P < .001. Another subgroup analysis between mild-moderate pneumonia versus severe-critical pneumonia showed SMD 0.69, 95% CI 0.25-1.13; P < .001, and no significant risk of publication bias (Begg test 0.063 and Egger test 0.057) in this subgroup. The heterogeneity was substantial, but the sensitivity analyses showed no significant change when individual study was excluded, which suggested the crediblity and stablity of our results.ConclusionsThe eosinophil counts had important value as an indicator of severity in patients with COVID-19.Prospero Registration NumberCRD42020205497.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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