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 VL - 7 IS - 3 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 - Maria del Mar Valdivia Salas AU - Javier Flandes Y1 - 2021/07/01 UR - http://openres.ersjournals.com/content/7/3/00165-2021.abstract N2 - Background The role of bronchoscopy in coronavirus disease 2019 (COVID-19) is a matter of debate.Patients and methods This observational multicentre 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 years; 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%). 147 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 hyperaemia (11.4%). The independent predictors of in-hospital mortality were: older age (OR 1.06; p<0.001), mucus plugs as indication for bronchoscopy (OR 1.60; p=0.041), absence of mucosal hyperaemia (OR 0.49; p=0.041) and the presence of haematic secretions (OR 1.79; p=0.032).Conclusion 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.Bronchoscopy is part of the armamentarium against #COVID19. It allows diagnosis, facilitates mechanical ventilation and provides prognostic information. This information could be used to refine healthcare pathways in order to improve outcomes. https://bit.ly/2QuAQOt ER -