The role of bronchoscopy in patients with SARS-CoV-2 pneumonia

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  • dc.contributor.author Arenas-De Larriva, Marisol
  • dc.contributor.author Sánchez-Font, Albert
  • dc.contributor.author Aguilar-Colindres, Ricardo
  • dc.contributor.author Flandes, Javier
  • dc.date.accessioned 2022-02-08T06:41:06Z
  • dc.date.available 2022-02-08T06:41:06Z
  • dc.date.issued 2021
  • dc.description.abstract 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.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Arenas-De Larriva M, Martín-DeLeon R, Urrutia Royo B, Fernández-Navamuel I, Gimenez Velando A, Nuñez García L et al. The role of bronchoscopy in patients with SARS-CoV-2 pneumonia. ERJ Open Res. 2021;7(3):00165-2021. DOI: 10.1183/23120541.00165-2021
  • dc.identifier.doi http://dx.doi.org/10.1183/23120541.00165-2021
  • dc.identifier.issn 2312-0541
  • dc.identifier.uri http://hdl.handle.net/10230/52432
  • dc.language.iso eng
  • dc.publisher European Respiratory Society
  • dc.relation.ispartof ERJ Open Res. 2021;7(3):00165-2021
  • dc.rights © The authors 2021. This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.title The role of bronchoscopy in patients with SARS-CoV-2 pneumonia
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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