RT Journal Article
SR Electronic
T1 The role of bronchoscopy in patients with SARS-CoV-2 pneumonia
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00165-2021
DO 10.1183/23120541.00165-2021
VO 7
IS 3
A1 Marisol Arenas-De Larriva
A1 Roberto Martín-DeLeon
A1 Blanca Urrutia Royo
A1 Iker Fernández-Navamuel
A1 Andrés Gimenez Velando
A1 Laura Nuñez García
A1 Carmen Centeno Clemente
A1 Felipe Andreo García
A1 Albert Rafecas Codern
A1 Carmen Fernández-Arias
A1 Virginia Pajares Ruiz
A1 Alfons Torrego Fernández
A1 Olga Rajas
A1 Gorane Iturricastillo
A1 Ricardo Garcia Lujan
A1 Lorena Comeche Casanova
A1 Albert Sánchez-Font
A1 Ricardo Aguilar-Colindres
A1 Roberto Larrosa-Barrero
A1 Ruth García García
A1 Rosa Cordovilla
A1 Ana Núñez-Ares
A1 Andrés Briones-Gómez
A1 Enrique Cases Viedma
A1 José Franco
A1 Javier Cosano Povedano
A1 Manuel Luis Rodríguez-Perálvarez
A1 Jose Joaquin Cebrian Gallardo
A1 Manuel Nuñez Delgado
A1 María Pavón-Masa
A1 Maria del Mar Valdivia Salas
A1 Javier Flandes
YR 2021
UL http://openres.ersjournals.com/content/7/3/00165-2021.abstract
AB 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