Frontiers in Medicine (Feb 2024)
Utility of bronchoalveolar lavage for COVID-19: a perspective from the Dragon consortium
- Sara Tomassetti,
- Luca Ciani,
- Valentina Luzzi,
- Leonardo Gori,
- Marco Trigiani,
- Leonardo Giuntoli,
- Federico Lavorini,
- Venerino Poletti,
- Claudia Ravaglia,
- Alfons Torrego,
- Fabien Maldonado,
- Robert Lentz,
- Francesco Annunziato,
- Laura Maggi,
- Gian Maria Rossolini,
- Gian Maria Rossolini,
- Simona Pollini,
- Simona Pollini,
- Ombretta Para,
- Greta Ciurleo,
- Alessandro Casini,
- Laura Rasero,
- Alessandro Bartoloni,
- Michele Spinicci,
- Mohammed Munavvar,
- Mohammed Munavvar,
- Stefano Gasparini,
- Camilla Comin,
- Marco Matucci Cerinic,
- Anna Peired,
- Monique Henket,
- Benoit Ernst,
- Renaud Louis,
- Jean-louis Corhay,
- Cosimo Nardi,
- Julien Guiot
Affiliations
- Sara Tomassetti
- Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Luca Ciani
- Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Valentina Luzzi
- Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Leonardo Gori
- Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Marco Trigiani
- Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Leonardo Giuntoli
- Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Federico Lavorini
- Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
- Venerino Poletti
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy
- Claudia Ravaglia
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy
- Alfons Torrego
- Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Fabien Maldonado
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
- Robert Lentz
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
- Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Laura Maggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Gian Maria Rossolini
- Department of Experimental Medicine, University of Florence, Florence, Italy
- Gian Maria Rossolini
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
- Simona Pollini
- Department of Experimental Medicine, University of Florence, Florence, Italy
- Simona Pollini
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
- Ombretta Para
- Internal Medicine Unit 1, AOU Careggi, Florence, Italy
- Greta Ciurleo
- 0Internal Medicine Unit 2, AOU Careggi, Florence, Italy
- Alessandro Casini
- 0Internal Medicine Unit 2, AOU Careggi, Florence, Italy
- Laura Rasero
- 1Department of Health Science, Clinical Innovations and Research Unit, Careggi University Hospital, Florence, Italy
- Alessandro Bartoloni
- 2Infectious and Tropical Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Michele Spinicci
- 2Infectious and Tropical Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Mohammed Munavvar
- 3School of Biological Sciences, The University of Manchester, Manchester, United Kingdom
- Mohammed Munavvar
- 4Department of Respiratory, Lancashire Teaching Hospital NHS Foundation Trust, Preston, United Kingdom
- Stefano Gasparini
- 5Interventional Pulmonology Unit, University Hospital Riuniti di Ancona, Ancona, Italy
- Camilla Comin
- 6Department of Experimental and Clinical Medicine Section of Surgery, Histopathology, and Molecular Pathology, University of Florence, Florence, Italy
- Marco Matucci Cerinic
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Anna Peired
- 7Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
- Monique Henket
- 8Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium
- Benoit Ernst
- 8Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium
- Renaud Louis
- 8Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium
- Jean-louis Corhay
- 8Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium
- Cosimo Nardi
- 9Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence, Florence, Italy
- Julien Guiot
- 8Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium
- DOI
- https://doi.org/10.3389/fmed.2024.1259570
- Journal volume & issue
-
Vol. 11
Abstract
Diagnosing COVID-19 and treating its complications remains a challenge. This review reflects the perspective of some of the Dragon (IMI 2-call 21, #101005122) research consortium collaborators on the utility of bronchoalveolar lavage (BAL) in COVID-19. BAL has been proposed as a potentially useful diagnostic tool to increase COVID-19 diagnosis sensitivity. In both critically ill and non-critically ill COVID-19 patients, BAL has a relevant role in detecting other infections or supporting alternative diagnoses and can change management decisions in up to two-thirds of patients. BAL is used to guide steroid and immunosuppressive treatment and to narrow or discontinue antibiotic treatment, reducing the use of unnecessary broad antibiotics. Moreover, cellular analysis and novel multi-omics techniques on BAL are of critical importance for understanding the microenvironment and interaction between epithelial cells and immunity, revealing novel potential prognostic and therapeutic targets. The BAL technique has been described as safe for both patients and healthcare workers in more than a thousand procedures reported to date in the literature. Based on these preliminary studies, we recognize that BAL is a feasible procedure in COVID-19 known or suspected cases, useful to properly guide patient management, and has great potential for research.
Keywords
