TY - JOUR T1 - The role of bronchoscopy in patients with SARS-CoV-2 pneumonia JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00165-2021 SP - 00165-2021 AU - Marisol Arenas-De Larriva AU - Roberto Martín-DeLeon AU - Blanca Urrutia Royo AU - Iker Fernández-Navamuel AU - Andrés Gimenez Velando AU - Laura Nuñez García AU - Carmen Centeno Clemente AU - Felipe Andreo García AU - Albert Rafecas Codern AU - Carmen Fernández-Arias AU - Virginia Pajares Ruiz AU - Alfons Torrego Fernández AU - Olga Rajas AU - Gorane Iturricastillo AU - Ricardo Garcia Lujan AU - Lorena Comeche Casanova AU - Albert Sánchez-Font AU - Ricardo Aguilar-Colindres AU - Roberto Larrosa-Barrero AU - Ruth García García AU - Rosa Cordovilla AU - Ana Núñez-Ares AU - Andrés Briones-Gómez AU - Enrique Cases Viedma AU - José Franco AU - Javier Cosano Povedano AU - Manuel Luis Rodríguez-Perálvarez AU - Jose Joaquin Cebrian Gallardo AU - Manuel Nuñez Delgado AU - María Pavón-Masa AU - Mª del Mar Valdivia Salas AU - Javier Flandes Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/04/22/23120541.00165-2021.abstract N2 - Background The role of bronchoscopy in coronavirus disease 2019 (COVID-19) is a matter of debate. Patients and methods: This observational multicenter study aimed to analyse the prognostic impact of bronchoscopic findings in a consecutive cohort of patients with suspected or confirmed COVID-19. Patients were enrolled at 17 hospitals from February to June, 2020. Predictors of in-hospital mortality were assessed by multivariate logistic regression.Results A total of 1027 bronchoscopies were performed in 515 patients (age 61.5±11.2; 73% men), stratified into a clinical suspicion cohort (n=30) and a COVID-19 confirmed cohort (n=485). In the clinical suspicion cohort, the diagnostic yield was 36.7%. In the COVID-19 confirmed cohort, bronchoscopies were predominantly performed in the intensive care unit (n=961; 96.4%) and major indications were: difficult mechanical ventilation (43.7%), mucus plugs (39%) and persistence of radiological infiltrates (23.4%). One hundred forty-seven bronchoscopies were performed to rule out superinfection, and diagnostic yield was 42.9%. There were abnormalities in 91.6% of bronchoscopies, the most frequent being mucus secretions (82.4%), haematic secretions (17.7%), mucus plugs (17.6%), and diffuse mucosal hyperemia (11.4%). The independent predictors of in-hospital mortality were: older age (Odds ratio [OR]=1.06; p<0.001), mucus plugs as indication for bronchoscopy (OR=1.60; p=0.041), absence of mucosal hyperemia (OR=0.49; p=0.041) and the presence of haematic secretions (OR=1.79; p=0.032).Conclusions Bronchoscopy may be indicated in carefully selected patients with COVID-19 to rule out superinfection and solve complications related to mechanical ventilation. The presence of haematic secretions in the distal bronchial tract may be considered a poor prognostic feature in COVID-19.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: M. Arenas-De Larriva reports a travel grant from Novartis and lecture fees from Ferrer outside the submitted work.Conflict of interest: Dr. Martin-Deleon has nothing to disclose.Conflict of interest: Dr. Urrutia Royo has nothing to disclose.Conflict of interest: Dr. Fernandez-Navamuel has nothing to disclose.Conflict of interest: Dr. Andrés Gimenez Velando has nothing to disclose.Conflict of interest: Dr. Laura Nuñez García has nothing to disclose.Conflict of interest: Dr. CENTENO CLEMENTE has nothing to disclose.Conflict of interest: Dr. Andreo García has nothing to disclose.Conflict of interest: Dr. Albert Rafecas Codern has nothing to disclose.Conflict of interest: Dr. Fernández-Arias has nothing to disclose.Conflict of interest: Dr. PAJARES has nothing to disclose.Conflict of interest: Dr. Torrego Fernández has nothing to disclose.Conflict of interest: Dr. RAJAS has nothing to disclose.Conflict of interest: Dr. Iturricastillo has nothing to disclose.Conflict of interest: Dr. GARCIA LUJAN has nothing to disclose.Conflict of interest: Dr. Comeche Casanova has nothing to disclose.Conflict of interest: Dr. Sánchez-Font has nothing to disclose.Conflict of interest: Dr. Aguilar-Colindres has nothing to disclose.Conflict of interest: Dr. Larrosa-Barrero has nothing to disclose.Conflict of interest: Dr. Ruth García García has nothing to disclose.Conflict of interest: Dr. Cordovilla has nothing to disclose.Conflict of interest: Dr. Núñez-Ares has nothing to disclose.Conflict of interest: Dr. Andrés Briones-Gómez has nothing to disclose.Conflict of interest: E. Cases Viedma reports lecture fees from Ambu outside the submitted work.Conflict of interest: Dr. Franco has nothing to disclose.Conflict of interest: J. Cosano Povedano report a travel grant from Izasa scientific outside the submitted work.Conflict of interest: Manuel Luis Rodríguez-Perálvarez reports lecture fees from Novartis, Astellas and Intercept outside the submitted work.Conflict of interest: Dr. Jose Joaquin Cebrian Gallardo has nothing to disclose.Conflict of interest: Dr. Nuñez Delgado has nothing to disclose.Conflict of interest: Dr. María Pavón-Masa has nothing to disclose.Conflict of interest: Mª del Mar Valdivia Salas has nothing to disclose.Conflict of interest: Dr. FLANDES has nothing to disclose. ER -