TY - JOUR
T1 - Bronchoalveolar lavage fluid characteristics and outcomes of invasively mechanically ventilated patients with COVID-19 pneumonia in Genoa, Italy
AU - Dentone, Chiara
AU - Vena, Antonio
AU - Loconte, Maurizio
AU - Grillo, Federica
AU - Brunetti, Iole
AU - Barisione, Emanuela
AU - Tedone, Elisabetta
AU - Mora, Sara
AU - Di Biagio, Antonio
AU - Orsi, Andrea
AU - De Maria, Andrea
AU - Nicolini, Laura
AU - Ball, Lorenzo
AU - Giacobbe, Daniele Roberto
AU - Magnasco, Laura
AU - Delfino, Emanuele
AU - Mastracci, Luca
AU - Mangerini, Rosa
AU - Taramasso, Lucia
AU - Sepulcri, Chiara
AU - Pincino, Rachele
AU - Bavastro, Martina
AU - Cerchiaro, Matteo
AU - Mikulska, Malgorzata
AU - Bruzzone, Bianca
AU - Icardi, Giancarlo
AU - Frisoni, Paolo
AU - Gratarola, Angelo
AU - Patroniti, Nicolò
AU - Pelosi, Paolo
AU - Bassetti, Matteo
PY - 2021/4/15
Y1 - 2021/4/15
N2 - BACKGROUND: The primary objective of the study is to describe the cellular characteristics of bronchoalveolar lavage fluid (BALF) of COVID-19 patients requiring invasive mechanical ventilation; the secondary outcome is to describe BALF findings between survivors vs non-survivors. MATERIALS AND METHODS: Patients positive for SARS-CoV-2 RT PCR, admitted to ICU between March and April 2020 were enrolled. At ICU admission, BALF were analyzed by flow cytometry. Univariate, multivariate and Spearman correlation analyses were performed. RESULTS: Sixty-four patients were enrolled, median age of 64 years (IQR 58-69). The majority cells in the BALF were neutrophils (70%, IQR 37.5-90.5) and macrophages (27%, IQR 7-49) while a minority were lymphocytes, 1%, TCD3+ 92% (IQR 82-95). The ICU mortality was 32.8%. Non-survivors had a significantly older age (p = 0.033) and peripheral lymphocytes (p = 0.012) were lower compared to the survivors. At multivariate analysis the percentage of macrophages in the BALF correlated with poor outcome (OR 1.336, CI95% 1.014-1.759, p = 0.039). CONCLUSIONS: In critically ill patients, BALF cellularity is mainly composed of neutrophils and macrophages. The macrophages percentage in the BALF at ICU admittance correlated with higher ICU mortality. The lack of lymphocytes in BALF could partly explain a reduced anti-viral response.
AB - BACKGROUND: The primary objective of the study is to describe the cellular characteristics of bronchoalveolar lavage fluid (BALF) of COVID-19 patients requiring invasive mechanical ventilation; the secondary outcome is to describe BALF findings between survivors vs non-survivors. MATERIALS AND METHODS: Patients positive for SARS-CoV-2 RT PCR, admitted to ICU between March and April 2020 were enrolled. At ICU admission, BALF were analyzed by flow cytometry. Univariate, multivariate and Spearman correlation analyses were performed. RESULTS: Sixty-four patients were enrolled, median age of 64 years (IQR 58-69). The majority cells in the BALF were neutrophils (70%, IQR 37.5-90.5) and macrophages (27%, IQR 7-49) while a minority were lymphocytes, 1%, TCD3+ 92% (IQR 82-95). The ICU mortality was 32.8%. Non-survivors had a significantly older age (p = 0.033) and peripheral lymphocytes (p = 0.012) were lower compared to the survivors. At multivariate analysis the percentage of macrophages in the BALF correlated with poor outcome (OR 1.336, CI95% 1.014-1.759, p = 0.039). CONCLUSIONS: In critically ill patients, BALF cellularity is mainly composed of neutrophils and macrophages. The macrophages percentage in the BALF at ICU admittance correlated with higher ICU mortality. The lack of lymphocytes in BALF could partly explain a reduced anti-viral response.
KW - Bronchoalveolar lavage fluid
KW - COVID-19
KW - Lymphocytes
KW - Macrophages
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U2 - 10.1186/s12879-021-06015-9
DO - 10.1186/s12879-021-06015-9
M3 - Article
C2 - 33858331
AN - SCOPUS:85104379165
VL - 21
SP - 353
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
IS - 1
ER -