Bronchoalveolar lavage fluid characteristics and outcomes of invasively mechanically ventilated patients with COVID-19 pneumonia in Genoa, Italy

BMC Infectious Diseases

Luca Mastracci¹  Federica Grillo¹  Iole Brunetti²  Maurizio Loconte²  Nicolò Patroniti³  Paolo Pelosi³  Lorenzo Ball³  Angelo Gratarola⁴  Paolo Frisoni⁴  Chiara Sepulcri⁵  Rachele Pincino⁵  Matteo Cerchiaro⁵  Martina Bavastro⁵  Giancarlo Icardi⁶  Andrea Orsi⁶  Sara Mora⁷  Elisabetta Tedone⁸  Rosa Mangerini⁸  Bianca Bruzzone⁹  Emanuele Delfino^1,10  Antonio Vena^1,10  Lucia Taramasso^1,10  Laura Nicolini^1,10  Chiara Dentone^1,10  Laura Magnasco^1,10  Matteo Bassetti^1,11  Daniele Roberto Giacobbe^1,11  Malgorzata Mikulska^1,11  Andrea De Maria^1,11  Antonio Di Biagio^1,11  Emanuela Barisione^1,12 

[1] 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;Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy;Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy;Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy;Department of Anesthesia and Resuscitation, Policlinico San Martino Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy;Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy;Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy;Hygiene Unit, San Martino Policlinico Hospital – IRCCS for Oncology and Neurosciences, Genoa, Italy;Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy;Flow Cytometry Unit, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy;Hygiene Unit, San Martino Policlinico Hospital – IRCCS for Oncology and Neurosciences, Genoa, Italy;Infectious Diseases Unit, San Martino Policlinico Hospital – IRCCS for Oncology and Neurosciences, Genoa, Italy;Infectious Diseases Unit, San Martino Policlinico Hospital – IRCCS for Oncology and Neurosciences, Genoa, Italy;Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy;Interventional Pulmonology Unit, Policlinico San Martino University Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy;

关键词: COVID-19;    Bronchoalveolar lavage fluid;    Macrophages;    Lymphocytes;   

DOI  :  10.1186/s12879-021-06015-9

来源: Springer

【 摘 要 】

BackgroundThe 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 methodsPatients 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.ResultsSixty-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).ConclusionsIn 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.

【 授权许可】

CC BY