%0 Journal Article
%A Arenas-De Larriva, Marisol
%A Martín-DeLeon, Roberto
%A Urrutia Royo, Blanca
%A Fernández-Navamuel, Iker
%A Gimenez Velando, Andrés
%A Nuñez García, Laura
%A Centeno Clemente, Carmen
%A Andreo García, Felipe
%A Rafecas Codern, Albert
%A Fernández-Arias, Carmen
%A Pajares Ruiz, Virginia
%A Torrego Fernández, Alfons
%A Rajas, Olga
%A Iturricastillo, Gorane
%A Garcia Lujan, Ricardo
%A Comeche Casanova, Lorena
%A Sánchez-Font, Albert
%A Aguilar-Colindres, Ricardo
%A Larrosa-Barrero, Roberto
%A García García, Ruth
%A Cordovilla, Rosa
%A Núñez-Ares, Ana
%A Briones-Gómez, Andrés
%A Cases Viedma, Enrique
%A Franco, José
%A Cosano Povedano, Javier
%A Rodríguez-Perálvarez, Manuel Luis
%A Cebrian Gallardo, Jose Joaquin
%A Nuñez Delgado, Manuel
%A Pavón-Masa, María
%A Valdivia Salas, Maria Del Mar
%A Flandes, Javier
%T The role of bronchoscopy in patients with SARS-CoV-2 pneumonia.
%D 2021
%@ 2312-0541
%U https://hdl.handle.net/10668/28346
%X The role of bronchoscopy in coronavirus disease 2019 (COVID-19) is a matter of debate. This observational multicentre study aimed to analyse the prognostic impact of bronchoscopic findings in a consecutive cohort of patients with suspected or confirmed COVID-19. Patients were enrolled at 17 hospitals from February to June 2020. Predictors of in-hospital mortality were assessed by multivariate logistic regression. A total of 1027 bronchoscopies were performed in 515 patients (age 61.5±11.2 years; 73% men), stratified into a clinical suspicion cohort (n=30) and a COVID-19 confirmed cohort (n=485). In the clinical suspicion cohort, the diagnostic yield was 36.7%. In the COVID-19 confirmed cohort, bronchoscopies were predominantly performed in the intensive care unit (n=961; 96.4%) and major indications were: difficult mechanical ventilation (43.7%), mucus plugs (39%) and persistence of radiological infiltrates (23.4%). 147 bronchoscopies were performed to rule out superinfection, and diagnostic yield was 42.9%. There were abnormalities in 91.6% of bronchoscopies, the most frequent being mucus secretions (82.4%), haematic secretions (17.7%), mucus plugs (17.6%), and diffuse mucosal hyperaemia (11.4%). The independent predictors of in-hospital mortality were: older age (OR 1.06; p Bronchoscopy may be indicated in carefully selected patients with COVID-19 to rule out superinfection and solve complications related to mechanical ventilation. The presence of haematic secretions in the distal bronchial tract may be considered a poor prognostic feature in COVID-19.
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