Sputum and Blood Eosinophilia Level of Patient With Chroni̇c Obstructive Pulmonary Disease (Copd) Exacerbation in Hospitalized

Abstract Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterised by persistent airflow limitation and frequent exacerbations. In patients with COPD exacerbations, whether steroid therapy should be administered via inhalation or the systemic route remains unclear. To address this, we aimed to evaluate the response of sputum and blood eosinophil counts to systemic and inhaled steroids in hospitalised patients with COPD exacerbation. Our study included 58 patients hospitalised at a chest disease clinic for the treatment of COPD exacerbation. Upon admission, pre-induced sputum samples were collected. Patients were then randomly assigned to receive either intravenous methylprednisolone (40 mg/day) as a single daily dose in addition to standard exacerbation treatment (n=29) or budesonide (0.50 mg) via nebulisation at 12-h intervals for 7 days (n=29). Sputum haemograms and eosinophils were evaluated on the 14th and 45th days of treatment. In patients receiving intravenous steroid treatment, sputum eosinophil percentages were significantly reduced on days 14 (0.36±0.72) and 45 (0.28±0.53) compared to those at baseline (0.86±1.22) (p=0.041). Although decreases in the percentage of eosinophils in sputum, eosinophil count, and percentage in blood were observed on the 14th and 45th days compared to baseline values in patients receiving inhaled steroid treatment, these changes were not statistically significant (p>0.05). Adding systemic steroids to the treatment of severe COPD exacerbations is a rational approach. Further studies with longer follow-up periods are needed to determine the role of eosinophil levels in the blood and sputum as a marker for deciding on intravenous and inhaled steroid treatments.