TY - JOUR
T1 - Utility of bronchoalveolar lavage for COVID-19 :
T2 - a perspective from the Dragon consortium
AU - Tomassetti, Sara
AU - Ciani, Luca
AU - Luzzi, Valentina
AU - Gori, Leonardo
AU - Trigiani, Marco
AU - Giuntoli, Leonardo
AU - Lavorini, Federico
AU - Poletti, Venerino
AU - Ravaglia, Claudia
AU - Torrego, Alfonso
AU - Maldonado, Fabien
AU - Lentz, Robert
AU - Annunziato, Francesco
AU - Maggi, Laura
AU - Rossolini, Gian Maria
AU - Pollini, Simona
AU - Para, Ombretta
AU - Ciurleo, Greta
AU - Casini, Alessandro
AU - Rasero, Laura
AU - Bartoloni, Alessandro
AU - Spinicci, Michele
AU - Munavvar, Mohammed
AU - Gasparini, Stefano
AU - Comin, Camilla
AU - Cerinic, Marco Matucci
AU - Peired, Anna
AU - Henket, Monique
AU - Ernst, Benoit
AU - Louis, Renaud
AU - Corhay, Jean-louis
AU - Nardi, Cosimo
AU - Guiot, Julien
PY - 2024
Y1 - 2024
N2 - Diagnosing COVID-19 and treating its complications remains a challenge. This review reflects the perspective of some of the Dragon (IMI 2-call 21, #101005122) research consortium collaborators on the utility of bronchoalveolar lavage (BAL) in COVID-19. BAL has been proposed as a potentially useful diagnostic tool to increase COVID-19 diagnosis sensitivity. In both critically ill and non-critically ill COVID-19 patients, BAL has a relevant role in detecting other infections or supporting alternative diagnoses and can change management decisions in up to two-thirds of patients. BAL is used to guide steroid and immunosuppressive treatment and to narrow or discontinue antibiotic treatment, reducing the use of unnecessary broad antibiotics. Moreover, cellular analysis and novel multi-omics techniques on BAL are of critical importance for understanding the microenvironment and interaction between epithelial cells and immunity, revealing novel potential prognostic and therapeutic targets. The BAL technique has been described as safe for both patients and healthcare workers in more than a thousand procedures reported to date in the literature. Based on these preliminary studies, we recognize that BAL is a feasible procedure in COVID-19 known or suspected cases, useful to properly guide patient management, and has great potential for research.
AB - Diagnosing COVID-19 and treating its complications remains a challenge. This review reflects the perspective of some of the Dragon (IMI 2-call 21, #101005122) research consortium collaborators on the utility of bronchoalveolar lavage (BAL) in COVID-19. BAL has been proposed as a potentially useful diagnostic tool to increase COVID-19 diagnosis sensitivity. In both critically ill and non-critically ill COVID-19 patients, BAL has a relevant role in detecting other infections or supporting alternative diagnoses and can change management decisions in up to two-thirds of patients. BAL is used to guide steroid and immunosuppressive treatment and to narrow or discontinue antibiotic treatment, reducing the use of unnecessary broad antibiotics. Moreover, cellular analysis and novel multi-omics techniques on BAL are of critical importance for understanding the microenvironment and interaction between epithelial cells and immunity, revealing novel potential prognostic and therapeutic targets. The BAL technique has been described as safe for both patients and healthcare workers in more than a thousand procedures reported to date in the literature. Based on these preliminary studies, we recognize that BAL is a feasible procedure in COVID-19 known or suspected cases, useful to properly guide patient management, and has great potential for research.
KW - Bronchoalveolar lavage
KW - COVID-19
KW - Infections
KW - Interstitial pneumonia
KW - Interventional pulmonology
U2 - 10.3389/fmed.2024.1259570
DO - 10.3389/fmed.2024.1259570
M3 - Review article
C2 - 38371516
SN - 2296-858X
VL - 11
JO - Frontiers in Medicine
JF - Frontiers in Medicine
ER -