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Vol. 60. Issue 7.
Pages 402-409 (July 2024)
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Vol. 60. Issue 7.
Pages 402-409 (July 2024)
Original Article
Clinical Characteristics and 2-Year Outcomes of Chronic Obstructive Pulmonary Disease Patients With High Blood Eosinophil Counts: A Population-based Prospective Cohort Study in China
Xiaohui Wua,1, Zhishan Denga,1, Fan Wua,b,1, Youlan Zhenga, Peiyu Huanga, Huajing Yanga, Ningning Zhaoa, Cuiqiong Daia, Jieqi Penga,b, Lifei Lua, Kunning Zhoua, Qi Wana, Gaoying Tanga, Shengtang Chenc, Yongqing Huangd, Changli Yangc, Shuqing Yud, Pixin Rana,b,
Corresponding author

Corresponding author.
, Yumin Zhoua,b,
Corresponding author

Corresponding author.
a State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
b Guangzhou National Laboratory, Guangzhou, China
c Wengyuan County People's Hospital, Shaoguan, China
d Lianping County People's Hospital, Heyuan, China
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Tables (3)
Table 1. Baseline Clinical Characteristics of Patients With Chronic Obstructive Pulmonary Disease.
Table 2. Association Between Blood Eosinophil Counts and Clinical Measurements in Patients With Chronic Obstructive Pulmonary Disease.
Table 3. Association Between Blood Eosinophil Counts and Annual Lung Function Decline in Patients With Chronic Obstructive Pulmonary Disease During the Study Follow-up Period.
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Additional material (1)

High blood eosinophil count (BEC) is a useful biomarker for guiding inhaled corticosteroid therapy in patients with chronic obstructive pulmonary disease (COPD), yet its implications in a community setting remain underexplored. This study aimed to elucidate the clinical characteristics and outcomes of COPD patients with high BEC within the Chinese community.


We obtained baseline and 2-year follow-up data from COPD patients (post-bronchodilator forced expiratory volume in 1 second/forced vital capacity <0.70) in the early COPD study. Patients with a BEC ≥300cells/μL were classified as the high BEC group. We assessed differences in the clinical characteristics and outcomes between high and low BEC patients. Subgroup analyses were conducted on COPD patients without a history of corticosteroid use or asthma.


Of the 897 COPD patients, 205 (22.9%) had high BEC. At baseline, high BEC patients exhibited a higher proportion of chronic respiratory symptoms, lower lung function, and more severe small airway dysfunction than low BEC patients. Over the 2-year period, high BEC patients experienced a significantly higher risk of acute exacerbations (relative risk: 1.28, 95% confidence interval: 1.09–1.49; P=0.002), even after adjusting for confounders. No significant difference was observed in lung function decline rates. The subgroup analysis yielded consistent results.


COPD patients with high BEC in a Chinese community exhibited poorer health status, more severe small airway dysfunction, and a higher risk of exacerbations. Future research should explore the pathological mechanisms underlying the poorer prognosis in patients with high BEC.

Chronic obstructive pulmonary disease
Blood eosinophil count
Cohort study
Chronic respiratory symptoms
Small airway dysfunction
Respiratory health outcomes


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