# A Comparative Study of Clinical, Hematological, and Biochemical Profiles in Eosinophilic and Non-eosinophilic Phenotypes of Chronic Obstructive Pulmonary Disease (COPD) During Acute Exacerbations

## TL;DR

This study compares two types of COPD during flare-ups, finding that patients with higher blood eosinophils have different inflammation and treatment patterns.

## Contribution

The study identifies distinct clinical and inflammatory profiles between eosinophilic and non-eosinophilic COPD exacerbations.

## Key findings

- Non-eosinophilic COPD patients had higher inflammation markers and longer hospital stays.
- Eosinophilic patients were more likely to receive inhaled corticosteroids.
- Very low eosinophil counts correlated with more systemic corticosteroid use.

## Abstract

Chronic obstructive pulmonary disease (COPD) continues to be a major global health concern, with emerging evidence suggesting that blood eosinophils may help distinguish between inflammatory subtypes during acute exacerbations. This observational cross-sectional study conducted at Baba Raghav Das (BRD) Medical College, Gorakhpur examined 60 patients with acute COPD exacerbations, categorized into eosinophilic (>300 cells/μL, n=20, 33.1%) and non-eosinophilic (≤300 cells/μL, n=40, 66.9%) phenotypes based on peripheral blood eosinophil counts. Non-eosinophilic patients demonstrated significantly higher systemic inflammation markers, including C-reactive protein levels (17.35 ± 3.8 vs 8.2 ± 5.3 mg/L, p<0.001), neutrophil percentages (79.5 ± 3.5% vs 66.2 ± 4.7%, p<0.001), and hepatic enzymes, along with longer hospital stays (6 vs 4 days, p=0.002). Eosinophilic patients were more likely to receive inhaled corticosteroids (66.0% vs 44.4%), while those with very low eosinophil counts (<150 cells/μL) more frequently received systemic corticosteroids (46.7% vs 19.1%, p=0.023). These findings suggest distinct inflammatory profiles between COPD phenotypes during acute exacerbations and support the potential utility of eosinophil-guided therapeutic approaches, though prospective studies are needed to confirm these associations and their clinical implications.