Abstract
BACKGROUND: Lung cancer is among the malignancies most vulnerable to coronavirus disease 2019 (COVID-19). Eosinophils have anti-tumor and antiviral effects. Since November 2021, the omicron variant of COVID-19 has become a topic of concern; however, the impact of eosinophils on the severity and outcomes of patients with lung cancer with omicron remains uncertain. This study aimed to utilize eosinophils to predict patient outcomes and guide the prevention and monitoring of omicron. METHODS: This study performed an analysis of 284 patients with lung cancer who were hospitalized in the second hospital of Jilin University, of whom 83 patients were confirmed to have omicron infection. Depending on the eosinophil counts, patients were divided into two groups: low and high eosinophil counts. The relationship between eosinophil counts and severity and outcomes was then analyzed. RESULTS: We found that omicron, especially severe-to-critical omicron, decreased survival in patients with lung cancer. Patients with omicron had a lower eosinophil count. Patients with eosinopenia (< 0.015 × 10(9)/L) were more likely to have an eastern cooperative oncology group performance status ≥ 2; be undergoing anti-cancer treatment; have comorbidities; and exhibit lower disease control rates, reduced 30-day survival, and shorter overall survival (median 75 days vs. not reached). Multivariate regression analysis revealed that the eosinophil count was an independent predictor of disease severity and survival in patients with lung cancer with omicron. CONCLUSION: Eosinopenia correlates with poor outcomes in patients with lung cancer with omicron, and the eosinophil count is an independent indicator for predicting the severity and outcomes in these patients.