Sputum eosinophilia linked to more asthma emergency visits, but not to more use of services in COPD

The edition in brief

In a retrospective cohort of 4,821 patients from a tertiary airway clinic linked to Ontario health records, sputum eosinophils above 3% were associated with more asthma-specific emergency department visits (RR 1.92, 95% CI 1.49 to 2.47 for 3% to 15%; RR 1.88, 95% CI 1.17 to 3.03 above 15%), whereas in COPD eosinophils were not associated with service use and high neutrophil counts were associated with all-cause hospitalisation (RR 1.71, 95% CI 1.11 to 2.64). An American Thoracic Society guideline update for children under 2 with interstitial lung disease strongly recommends rapid broad genetic testing in infants with respiratory failure, keeps chest CT as part of evaluation, and recommends lung biopsy and transplant referral in defined circumstances. A single-centre trial of 88 patients with acute respiratory failure and retained secretions found high-frequency chest wall oscillation reduced therapeutic bronchoscopy from 31.8% to 13.6% (unadjusted p = 0.042; adjusted OR 0.336, 95% CI 0.111 to 1.021), with shorter stays in exploratory analyses. A retrospective study of 68 patients with EGPA who failed mepolizumab found complete response in 32% and partial in 25% after switching to benralizumab.