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 64years (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.

Bronchoalveolar lavage fluid characteristics and outcomes of invasively mechanically ventilated patients with COVID-19 pneumonia in Genoa, Italy

Dentone, Chiara;Vena, Antonio;Loconte, Maurizio;Grillo, Federica;Brunetti, Iole;Barisione, Emanuela;Tedone, Elisabetta;Mora, Sara;Di Biagio, Antonio;Orsi, Andrea;De Maria, Andrea;Nicolini, Laura;Ball, Lorenzo;Giacobbe, Daniele Roberto;Magnasco, Laura;Delfino, Emanuele;Mastracci, Luca;Mangerini, Rosa;Taramasso, Lucia;Sepulcri, Chiara;Pincino, Rachele;Bavastro, Martina;Cerchiaro, Matteo;Mikulska, Malgorzata;Bruzzone, Bianca;Icardi, Giancarlo;Frisoni, Paolo;Gratarola, Angelo;Patroniti, Nicolò;Pelosi, Paolo;Bassetti, Matteo
2021-01-01

Abstract

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 64years (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.
File in questo prodotto:
File Dimensione Formato  
12879_2021_Article_6015.pdf

accesso aperto

Descrizione: Articolo su rivista
Tipologia: Documento in versione editoriale
Dimensione 665.31 kB
Formato Adobe PDF
665.31 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11567/1046231
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 19
  • ???jsp.display-item.citation.isi??? 15
social impact