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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.
  • Dentone C; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy. Chiara.dentone@hsanmartino.it.
  • Vena A; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Loconte M; Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Grillo F; Anatomic Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
  • Brunetti I; Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Barisione E; Interventional Pulmonology Unit, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
  • Tedone E; Flow Cytometry Unit, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
  • Mora S; Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy.
  • Di Biagio A; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Orsi A; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • De Maria A; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Nicolini L; Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Ball L; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Giacobbe DR; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Magnasco L; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Delfino E; Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Mastracci L; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
  • Mangerini R; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Taramasso L; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Sepulcri C; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Pincino R; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Bavastro M; Anatomic Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
  • Cerchiaro M; Flow Cytometry Unit, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
  • Mikulska M; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Bruzzone B; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Icardi G; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Frisoni P; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Gratarola A; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Patroniti N; Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
  • Pelosi P; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Bassetti M; Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
BMC Infect Dis ; 21(1): 353, 2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1190057
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 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Bronchoalveolar Lavage Fluid / COVID-19 / Leukocyte Count Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06015-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiration, Artificial / Bronchoalveolar Lavage Fluid / COVID-19 / Leukocyte Count Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06015-9