Bronchoalveolar lavage-based COVID-19 testing in patients with cancer.
Hematol Oncol Stem Cell Ther
; 14(1): 65-70, 2021 Mar.
Article
in English
| MEDLINE | ID: covidwho-836965
ABSTRACT
OBJECTIVE/BACKGROUND:
A few case reports in the setting of coronavirus disease 2019 (COVID-19) and multiplex polymerase chain reaction (PCR)-based assays for common respiratory pathogens have shown a higher yield of bronchoalveolar lavage (BAL) samples than upper airway specimens in immunocompromised patients.METHODS:
A retrospective study was conducted reviewing patients diagnosed with COVID-19 at the Medical College of Wisconsin (Milwaukee, WI, USA) between March 13, 2020 and June 11, 2020. All patients tested positive for SARS-CoV-2 via real-time reverse transcriptase PCR (RT-PCR), through a nasopharyngeal or a bronchoscopy specimen.RESULTS:
During the study period, 53 bronchoscopy procedures were performed at the institution, of which five patients tested positive for COVID-19. Of the five patients, three underwent BAL testing based on high clinical suspicion for COVID-19 after the nasopharyngeal (NP) swab(s) was negative. All three patients had underlying cancers and had lymphopenia for a considerable duration prior to being diagnosed with COVID-19. Two patients had better outcomes that could be attributed to earlier BAL specimen testing resulting in timely medical intervention.CONCLUSION:
This study underscores the need for early lower respiratory tract sampling, whenever possible, in patients with cancer and prolonged lymphopenia. High clinical suspicion ought to supersede false-negative NP reverse transcriptase-PCR as early bronchoscopic evaluation in cancer patients, who are either receiving active treatment or are immunosuppressed, can allow timely institution of efficacious treatment, enrollment into clinical trials, as well as effective infection control. In the apt clinical setting in patients with cancer, presumptive treatment may also be considered to minimize exposure to healthcare providers and proceduralists.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Bronchoalveolar Lavage
/
COVID-19 Testing
/
SARS-CoV-2
/
COVID-19
/
Neoplasms
Type of study:
Case report
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
Hematol Oncol Stem Cell Ther
Journal subject:
Hematology
/
Neoplasms
Year:
2021
Document Type:
Article
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