Utility and safety of bronchoscopy during the SARS-CoV-2 outbreak in Italy: a retrospective, multicentre study

Mondoni, Michele; Papa, Giuseppe Francesco Sferrazza; Rinaldo, Rocco Francesco; Faverio, Paola; Marruchella, Almerico; D’Arcangelo, Francesca D.; Pesci, Alberto; Pasini, Simone; Henchi, Sonia; Cipolla, Giuseppe; Tarantini, Francesco; Giuliani, Lisa; Marco, Fabiano Di; Saracino, Laura; Tomaselli, Stefano; Corsico, Angelo Guido; Gasparini, Stefano; Bonifazi, Martina; Zuccatosta, Lina; Saderi, Laura; Pellegrino, Giulia Michela; Davì, Matteo; Carlucci, Paolo; Centanni, Stefano; Sotgiu, Giovanni

doi:10.1183/13993003.02767-2020

Cited by 44 publications

(79 citation statements)

References 15 publications

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“…All bronchoscopies were performed at both centers for diagnostic purposes in order to investigate the presence of other co-infections and no complications related to bronchoscopy occurred in patients [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome

et al. 2020

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly reached pandemic proportions. Given that the main target of SARS-CoV-2 are lungs leading to severe pneumonia with hyperactivation of the inflammatory cascade, we conducted a prospective study to assess alveolar inflammatory status in patients with moderate to severe COVID-19. Methods Diagnostic bronchoalveolar lavage (BAL) was performed in 33 adult patients with SARS-CoV-2 infection by real-time PCR on nasopharyngeal swab admitted to the Intensive care unit (ICU) (n = 28) and to the Intermediate Medicine Ward (IMW) (n = 5). We analyze the differential cell count, ultrastructure of cells and Interleukin (IL)6, 8 and 10 levels. Results ICU patients showed a marked increase in neutrophils (1.24 × 105 ml− 1, 0.85–2.07), lower lymphocyte (0.97 × 105 ml− 1, 0.024–0.34) and macrophages fractions (0.43 × 105 ml− 1, 0.34–1.62) compared to IMW patients (0.095 × 105 ml− 1, 0.05–0.73; 0.47 × 105 ml− 1, 0.28–1.01 and 2.14 × 105 ml− 1, 1.17–3.01, respectively) (p < 0.01). Study of ICU patients BAL by electron transmission microscopy showed viral particles inside mononuclear cells confirmed by immunostaining with anti-viral capsid and spike antibodies. IL6 and IL8 were significantly higher in ICU patients than in IMW (IL6 p < 0.01, IL8 p < 0.0001), and also in patients who did not survive (IL6 p < 0.05, IL8 p = 0.05 vs. survivors). IL10 did not show a significant variation between groups. Dividing patients by treatment received, lower BAL concentrations of IL6 were found in patients treated with steroids as compared to those treated with tocilizumab (p < 0.1) or antivirals (p < 0.05). Conclusions Alveolitis, associated with COVID-19, is mainly sustained by innate effectors which showed features of extensive activation. The burden of pro-inflammatory cytokines IL6 and IL8 in the broncho-alveolar environment is associated with clinical outcome.

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Section: Methodsmentioning

confidence: 99%

Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome

et al. 2020

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“…During the first wave of the pandemic, we rapidly observed, as highlighted by others ( 5 , 6 ), an increased need for bronchoscopy in patients with COVID-19–associated ARDS requiring mechanical ventilation, mainly for bronchoaspiration but also, in some cases, to perform BAL for microbiological sampling. The ability of BAL to confirm COVID-19 was also demonstrated, in case of previous negative nasopharyngeal swab(s) in patients, intubated or not, with clinical concern for this diagnosis ( 6 – 8 ). Nevertheless, the value of BAL has not been evaluated so far for further microbiological workup after noninvasive diagnostic tests were exhausted.…”

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confidence: 88%

Bronchoalveolar Lavage in Patients with COVID-19 with Invasive Mechanical Ventilation for Acute Respiratory Distress Syndrome

et al. 2021

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“…2020 [1], raising issues on acute phase management and, later on, the management of its long-term sequelae. Cardiopulmonary exercise test (CPET), which is the gold standard for the evaluation of exercise capacity, is included in the list of examinations of the European Respiratory Society (ERS)/American Thoracic Society (ATS) task force for the follow-up of COVID-19 patients [2].…”

Section: Sars-cov2 and The Related Coronavirus Disease 2019 (Covid-19) Hit Europe In Februarymentioning

confidence: 99%

Deconditioning as main mechanism of impaired exercise response in COVID-19 survivors

et al. 2021

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Utility and safety of bronchoscopy during the SARS-CoV-2 outbreak in Italy: a retrospective, multicentre study

Abstract: Take home message: utility and safety of bronchoscopy during SARS-CoV-2 outbreak Funding: the work is funded by Università degli Studi di Milano in the context of the Registry for COVID19 Emergency (RECOVER) electronic database

Cited by 44 publications

References 15 publications

Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome

Broncho-alveolar inflammation in COVID-19 patients: a correlation with clinical outcome

Bronchoalveolar Lavage in Patients with COVID-19 with Invasive Mechanical Ventilation for Acute Respiratory Distress Syndrome

Deconditioning as main mechanism of impaired exercise response in COVID-19 survivors

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