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Challenges for NHS hospitals during covid-19 epidemic

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1117 (Published 20 March 2020) Cite this as: BMJ 2020;368:m1117

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Re: Challenges for NHS hospitals during covid-19 epidemic

Dear Editor

I read with interest your article. Considering the current COVID-19 outbreak, looking at investigation results in a small cohort of patients with suspected COVID-19 infection, the author observed that 10 out of 13 patients (77%) had a reduced eosinophil count of 0.0.

It is a known fact that eosinophils are potential targets of virus attacks and more importantly that eosinophils can reduce virus infectivity (1). It has been shown that both isolated human eosinophils and the major eosinophil ribonuclease, EDN (Eosinophil-derived neurotoxin) are effective against viruses (2).

This leads us to two simple hypotheses:

(1) In patients presenting with or without symptoms of temperature, cough or breathlessness, currently considered to be COVID-19 symptoms (3), a simple blood test in the form of a Full Blood Count to check the eosinophil count might be a quick enough test for medical staff be able to take adequate precautionary measures and initiate early management.

(2) Perhaps our research into finding a cure for the COVID-19 infection should concentrate on eosinophils and their derivatives if not already being done.

References
(1) Rosenberg, H.F., Dyer, K.D. & Domachowske, J.B. Eosinophils and their interactions with respiratory virus pathogens. Immunol Res 43, 128–137 (2009). https://doi.org/10.1007/s12026-008-8058-5
(2) Joseph B. Domachowske, Kimberly D. Dyer, Cynthia A. Bonville, Helene F. Rosenberg, Recombinant Human Eosinophil-Derived Neurotoxin/RNase 2 Functions as an Effective Antiviral Agent against Respiratory Syncytial Virus, The Journal of Infectious Diseases, Volume 177, Issue 6, June 1998, Pages 1458–1464, https://doi.org/10.1086/515322
(3) World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report-51. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio... Updated 2020. Accessed March 26, 2020.

Competing interests: No competing interests

26 March 2020
George Alex
Surgeon
Hull, UK