Portal de investigación
The role of bronchoscopy in patients with SARS-CoV-2 pneumonia
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Arenas-De Larriva, M
- Martin-DeLeon, R
- Royo, BU
- Fernandez-Navamuel, I
- Velando, AG
- Garcia, LN
- Clemente, CC
- Garcia, FA
- Codern, AR
- Fernandez-Arias, C
- Ruiz, VP
- Fernandez, AT
- Rajas, O
- Iturricastillo, G
- Lujan, RG
- Casanova, LC
- Sanchez-Font, A
- Aguilar-Colindres, R
- Larrosa-Barrero, R
- Garcia, RG
- Cordovilla, R
- Nunez-Ares, A
- Franco, J
- Povedano, JC
- Rodriguez-Peralvarez, ML
- Gallardo, JJC
- Delgado, MN
- Pavon-Masa, M
- Salas, MDV
- Flandes, J
Grupos
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.
Datos de la publicación
- ISSN/ISSNe:
- 2312-0541, 2312-0541
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 34258257
- Factor de Impacto:
- 0,944 SCImago ℠
- Cuartil:
- Q2 SCImago ℠
ERJ Open Research EUROPEAN RESPIRATORY SOC JOURNALS LTD
Citas Recibidas en Web of Science: 18
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