Page 73 - ECBIP 2021_Program

MODERATED e-POSTER SESSION 06:
Infectious Diseases and COVID-19
PP44
Introduction: The diagnosis of COVID-19 is based on symptoms, history of infection exposure, laboratory and radiological findings and is confirmed by real-time reverse transcriptase (RT)-PCR for SARS-CoV-2 detection in nasal or nasopharyngeal swabs. In case of suggestive clinical/radiological features but negative swab, bronchoalveolar lavage (BAL) can be indicated as a complementary diagnostic tool. However, risk-benefit profile of this procedure in diagnostic work-up of COVID-19 pneumonia has not yet been defined. The aim of the present study is to investigate the role of BAL in the diagnosis of COVID-19 in subjects with suggestive clinical/radiological features and negative nasal or nasopharyngeal RT-PCR for SARS-CoV-2.
Methods: We performed a retrospective study including consecutive patients admitted to emergency department of Azienda Ospedaliero Universitaria “Ospedali Riuniti” (Ancona, Italy) for suspected COVID-19 pneumonia undergoing BAL after at least one negative nasopharyngeal swab, between March 2020 and April 2021.
Results: Overall, 123 patients were included in the present study and almost all patients (n=115, 93%) presented with a CT pattern suggestive for SarsCov-2 pneumonia. Nine patients had BAL positive for SARS-Cov-2 (7%), and all exhibited typical or indeterminate pattern at CT scan. Among 114 patients with BAL negative, other pathogens were isolated in 35 cases (28%).
Conclusion: BAL allowed to achieve a definite COVID-19 diagnosis in 7% of patients with negative swab and to change management in 28% of study population. Our data confirmed the relevant role of BAL in the diagnostic work-up of COVID-19 and in finding alternative diagnoses. In selected cases with high clinical suspicion of SARS-Cov-2, BAL can be considered as complementary test to identify COVID-19 patients, avoiding the spread of the virus in departments without appropriate containment measures, and to rule out other infections. However, the potential for virus spreading from subjects with SARS-CoV-2 positivity in lower airways only, has yet to be defined.
ROLE OF BAL IN THE DIAGNOSTIC WORK-UP OF COVID-19
Francesco Porcarelli1, Martina Bonifazi1,2, Lina Zuccatosta2, Stefano Gasparini1,2
1 Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Region, Ancona, Italy 2 Pulmonary Disease Unit, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Ancona, Italy
ECBIP 2021 73
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts