Arenas-De Larriva, MarisolMartín-DeLeon, RobertoUrrutia Royo, BlancaFernández-Navamuel, IkerGimenez Velando, AndrésNuñez García, LauraCenteno Clemente, CarmenAndreo García, FelipeRafecas Codern, AlbertFernández-Arias, CarmenPajares Ruiz, VirginiaTorrego Fernández, AlfonsRajas, OlgaIturricastillo, GoraneGarcia Lujan, RicardoComeche Casanova, LorenaSánchez-Font, AlbertAguilar-Colindres, RicardoLarrosa-Barrero, RobertoGarcía García, RuthCordovilla, RosaNúñez-Ares, AnaBriones-Gómez, AndrésCases Viedma, EnriqueFranco, JoséCosano Povedano, JavierRodríguez-Perálvarez, Manuel LuisCebrian Gallardo, Jose JoaquinNuñez Delgado, ManuelPavón-Masa, MaríaValdivia Salas, Maria Del MarFlandes, Javier2025-01-072025-01-072021-07-122312-0541https://hdl.handle.net/10668/28346The 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.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/research article34258257open access10.1183/23120541.00165-2021PMC8183029https://openres.ersjournals.com/content/erjor/7/3/00165-2021.full.pdfhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8183029/pdf