Utility of bronchoalveolar lavage for COVID-19: a perspective from the Dragon consortium.

Autor:	Tomassetti S; Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Ciani L; Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Luzzi V; Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Gori L; Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Trigiani M; Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Giuntoli L; Interventional Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Lavorini F; Pulmonology Unit, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy., Poletti V; Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy., Ravaglia C; Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy., Torrego A; Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Maldonado F; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States., Lentz R; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States., Annunziato F; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Maggi L; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Rossolini GM; Department of Experimental Medicine, University of Florence, Florence, Italy.; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy., Pollini S; Department of Experimental Medicine, University of Florence, Florence, Italy.; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy., Para O; Internal Medicine Unit 1, AOU Careggi, Florence, Italy., Ciurleo G; Internal Medicine Unit 2, AOU Careggi, Florence, Italy., Casini A; Internal Medicine Unit 2, AOU Careggi, Florence, Italy., Rasero L; Department of Health Science, Clinical Innovations and Research Unit, Careggi University Hospital, Florence, Italy., Bartoloni A; Infectious and Tropical Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Spinicci M; Infectious and Tropical Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Munavvar M; School of Biological Sciences, The University of Manchester, Manchester, United Kingdom.; Department of Respiratory, Lancashire Teaching Hospital NHS Foundation Trust, Preston, United Kingdom., Gasparini S; Interventional Pulmonology Unit, University Hospital Riuniti di Ancona, Ancona, Italy., Comin C; Department of Experimental and Clinical Medicine Section of Surgery, Histopathology, and Molecular Pathology, University of Florence, Florence, Italy., Cerinic MM; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Peired A; Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy., Henket M; Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium., Ernst B; Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium., Louis R; Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium., Corhay JL; Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium., Nardi C; Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence, Florence, Italy., Guiot J; Department of Respiratory Medicine, Universitary Hospital of Liège, Liège, Belgium.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2024 Feb 02; Vol. 11, pp. 1259570. Date of Electronic Publication: 2024 Feb 02 (Print Publication: 2024).
DOI:	10.3389/fmed.2024.1259570
Abstrakt:	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. Competing Interests: ST declares consultancy and speaker’s fees from Roche and Boehringer Ingelheim. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Tomassetti, Ciani, Luzzi, Gori, Trigiani, Giuntoli, Lavorini, Poletti, Ravaglia, Torrego, Maldonado, Lentz, Annunziato, Maggi, Rossolini, Pollini, Para, Ciurleo, Casini, Rasero, Bartoloni, Spinicci, Munavvar, Gasparini, Comin, Cerinic, Peired, Henket, Ernst, Louis, Corhay, Nardi and Guiot.)
Databáze:	MEDLINE
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