Eosinophil and neutrophil-to-lymphocyte ratios as predictors of hospitalization in children with asthma exacerbation

Abstract Context Moderate to severe asthmatic children are usually hospitalized after a severe exacerbation. Neutrophils and eosinophils play a critical part in the pathophysiology of asthma. In those with uncontrolled asthma, the mean neutrophil-to-lymphocyte ratio (NLR) increases. The objective was to evaluate blood eosinophil count and NLR as potential indicators of hospitalization in severe exacerbations of pediatric asthma. Patients and methods The blood eosinophil count and NLR were assessed in 50 patients with moderate-to-severe asthma exacerbation. Results Regarding nonadherence to prescribed therapy, presence of atopic disease, and antibiotic therapy, they were statistically significantly higher in the hospitalized group ( P =0.005, 0.001, and 0.001, respectively). Moreover, the mean total leukocyte count and C-reactive protein levels were statistically higher in the hospitalized group compared with the nonhospitalized group ( P =0.034 and 0.0010, respectively). The mean blood neutrophil count (5.58±3.08 vs. 3.61±2.02, P =0.011), and the mean blood eosinophil count (0.37±0.32 vs. 0.19±0.13, P =0.031) were statistically substantially higher in hospitalized children than the nonhospitalized group. The mean NLR was higher in the hospitalized children than in the nonhospitalized children with no statistically significant difference (2.64±3.61 vs. 1.21±1.17, P =0.061). Conclusions The total leukocyte count, the mean neutrophil count, and the mean blood eosinophil count were elevated in asthma exacerbation children who required hospitalization and could be used as a predictor for uncontrolled asthma with high sensitivity and specificity. These are rapid, inexpensive, and simply applicable tests from standard complete blood count tests, making them a potential asthma exacerbation bedside test.