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Epidemiology, clinical presentation, and outcomes of 620 patients with eosinophilia in the intensive care unit

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A Correction to this article was published on 12 April 2023

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Abstract

Purpose

Although eosinophil-induced manifestations can be life-threatening, studies focusing on the epidemiology and clinical manifestations of eosinophilia in the intensive care unit (ICU) are lacking.

Methods

A retrospective, national, multicenter (14 centers) cohort study over 6 years of adult patients who presented with eosinophilia ≥ 1 × 109/L on two blood samples performed from the day before admission to the last day of an ICU stay.

Results

620 patients (0.9% of all ICU hospitalizations) were included: 40% with early eosinophilia (within the first 24 h of ICU admission, ICU-Eo1 group) and 56% with delayed (> 24 h after ICU admission, ICU-Eo2 group) eosinophilia. In ICU-Eo1, eosinophilia was mostly due to respiratory (14.9%) and hematological (25.8%) conditions, frequently symptomatic (58.1%, mainly respiratory and cardiovascular manifestations) requiring systemic corticosteroids in 32.2% of cases. In ICU-Eo2, eosinophil-related organ involvement was rare (25%), and eosinophilia was mostly drug-induced (46.8%). Survival rates at day 60 (D60) after ICU admission were 21.4% and 17.2% (p = 0.219) in ICU-Eo1 and ICU-Eo2 patients, respectively. For ICU-Eo1 patients, in multivariate analysis, risk factors for death at D60 were current immunosuppressant therapy at ICU admission, eosinophilia of onco-hematological origin and the use of vasopressors at ICU admission, whereas older age and the use of vasopressors or mechanical ventilation at the onset of eosinophilia were associated with a poorer prognosis for ICU-Eo2 patients.

Conclusion

Eosinophilia ≥ 1 × 109/L is not uncommon in the ICU. According to the timing of eosinophilia, two subsets of patients requiring different etiological workups and management can be distinguished.

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Data availability

The data that support the findings of this study are available on request from the corresponding author [AG].

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Acknowledgements

We acknowledge Sylvie Meireles and Anne-Gaëlle Si Larbi for their help in data collection. We are grateful to Polly Gobin for editorial assistance.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Foch Hospital, Suresnes, France

    Antoine Gaillet, Kewin Panel & Matthieu Groh

  2. National Reference Center for Hypereosinophilic Syndromes (CEREO), Hôpital Foch, 40, Rue Worth, 92151, Suresnes Cedex, France

    Antoine Gaillet, Jean-Emmanuel Kahn, Guillaume Lefèvre, Kewin Panel & Matthieu Groh

  3. Medical Intensive Care Unit, Hôpitaux Universitaires Henri Mondor, AP-HP, 1 Rue Gustave Eiffel, 94010, Créteil Cedex, France

    Antoine Gaillet, Pierre Bay, Nicolas de Prost & Armand Mekonsto-Dessap

  4. Medical Intensive Care Unit, Cardiological Institute, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France

    Pierre Bay & Marc Pineton de Chambrun

  5. Medical Intensive Care Unit, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris AP-HP Centre, Université Paris Cité, Paris, France

    Edwige Péju & Frédéric Pène

  6. Medical Intensive Care Unit, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France

    Hafid Ait-Oufella

  7. Medical Intensive Care Unit, APHP, Hôpital Saint-Louis, Paris University, 1 Avenue Claude Vellefaux, 75010, Paris, France

    Elie Azoulay & Asma Mabrouki

  8. Intensive Care Medicine Department, Lapeyronie Hospital, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34090, Montpellier, France

    Nacime Benchabane & Romaric Larcher

  9. Medical Intensive Care Unit, Foch Hospital, Suresnes, France

    Charles Cerf

  10. Medical Intensive Care Unit, CHU Avicenne, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, 93000, Bobigny, France

    Yves Cohen & Yacine Tandjaoui-Lambiotte

  11. Department of Nephrology and Organ Transplantation, Centre de Référence Des Maladies Rénales Rares, Centre Hospitalier Universitaire de Toulouse, Toulouse, France

    Stanislas Faguer

  12. Medical Intensive Care Unit, Ambroise Paré Hospital, AP-HP, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France

    Guillaume Geri & Antoine Vieillard-Baron

  13. Medical Intensive Care Unit, Rouen University Hospital, 37 Boulevard Gambetta, 76031, Rouen Cedex, France

    Steven Grangé & Antoine Herault

  14. Department of Internal Medicine, Hôpital Ambroise-Paré, Boulogne-Billancourt, France

    Jean-Emmanuel Kahn

  15. Medical Intensive Care Unit, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon, France

    Louis Kreitmann & Auguste Dargent

  16. Department of Internal Medicine, Lille University Hospital, Lille, France

    Guillaume Lefèvre

  17. Medical Intensive Care Unit, CHU Dijon Bourgogne, Dijon, France

    Jean-Pierre Quenot

  18. INSERM U1272 Hypoxia and Lung, Bobigny, France

    Yacine Tandjaoui-Lambiotte

  19. Medical Intensive Care Unit, Université Paris Diderot/Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Paris, France

    Jean-Francois Timsit

  20. CHU Lille, Inserm, U1286 - INFINITE - Institute for Translational Research in Inflammation, University of Lille, Lille, France

    Matthieu Groh

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  1. Antoine Gaillet
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Contributions

AG and MG conceived the study. All authors contributed to data collection. AG and MG analyzed data. AG and MG provided graphical support. AG and MG drafted the manuscript. All authors contributed to revision of the final version of the manuscript.

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Correspondence to Antoine Gaillet.

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Conflicts of interest

GL: consulting fees from GlaxoSmithKline and AstraZeneca; JEK: consulting fees from GlaxoSmithKline and AstraZeneca; MG: consulting fees from GlaxoSmithKline and AstraZeneca.

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The original online version of this article was revised: In this article the hyphen was missing from the surname of the author Armand Mekonsto-Dessap.

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Gaillet, A., Bay, P., Péju, E. et al. Epidemiology, clinical presentation, and outcomes of 620 patients with eosinophilia in the intensive care unit. Intensive Care Med 49, 291–301 (2023). https://doi.org/10.1007/s00134-022-06967-9

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