Cytopathology of Bronchoalveolar Lavages in COVID-19 Pneumonia: A Pilot Study

Autor: Valentina Canini, Stefania Galimberti, Francesca Bono, Vincenzo L'Imperio, Marco Giani, Giuseppe Paciocco, Roberto Rona, Paolo Calzavacca, Giuseppe Foti, Giulia Capitoli, Filippo Fraggetta, Ahmed Nasr, Fabio Pagni, Andrea Gianatti
Přispěvatelé: Canini, V, Bono, F, Calzavacca, P, Capitoli, G, Foti, G, Fraggetta, F, Galimberti, S, Gianatti, A, Giani, M, Nasr, A, Paciocco, G, Pagni, F, Rona, R, L'Imperio, V
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
Cancer Research
Pathology
medicine.medical_specialty
multinucleated giant cell
Pneumonia
Viral
Pilot Projects
030209 endocrinology & metabolism
severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)
03 medical and health sciences
0302 clinical medicine
Intensive care
Humans
Medicine
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Aged
Retrospective Studies
medicine.diagnostic_test
SARS-CoV-2
business.industry
bronchoalveolar lavage (BAL)
COVID-19
Retrospective cohort study
Original Articles
Middle Aged
medicine.disease
Staining
Pneumonia
Bronchoalveolar lavage
Oncology
Giant cell
Cytopathology
030220 oncology & carcinogenesis
Absolute neutrophil count
coronavirus disease 2019 (COVID-19)
Female
Original Article
coronavirus disease 2019 (COVID‐19)
business
Bronchoalveolar Lavage Fluid
Zdroj: Cancer Cytopathology
Popis: BACKGROUND Bronchoalveolar lavage (BAL) in patients with severe coronavirus disease 2019 (COVID‐19) may provide additional and complementary findings for the management of these patients admitted to intensive care units (ICUs). This study addresses the cytological features of the infection and highlights the more influential inflammatory components. The correlation between pathological variables and clinical data is also analyzed. METHODS The authors performed a retrospective analysis of the cytopathological features of BAL in 20 COVID‐19 patients and 20 members of a matched cohort from a critical ICU who had acute respiratory distress syndrome caused by other pulmonary conditions. RESULTS A comparison of the controls (n = 20) and the COVID‐19 patients (n = 20) revealed that the latter had a higher neutrophil count (median, 63.8% of the cell count) with lower percentages of macrophages and lymphocytes. An increase in the expression of CD68‐positive, monocytic multinucleated giant cells (MGCs) was reported; megakaryocytes were not detected on CD61 staining. Perls staining showed isolated elements. In situ RNA analysis demonstrated scattered chromogenic signals in type II pneumocytes. An ultrastructural analysis confirmed the presence of intracytoplasmic vacuoles containing rounded structures measuring 140 nm in diameter (putative viral particles). In COVID‐19 patients, the clinicopathological correlation revealed a positive correlation between lactate dehydrogenase values and MGCs (r = 0.54). CONCLUSIONS The analysis of BAL samples might be implemented as a routine practice for the evaluation of COVID‐19 patients in ICUs in the appropriate clinical scenario. Additional studies using a larger sample size of patients who developed COVID‐19 during the second wave of the epidemic in the autumn of 2020 are needed to further support our findings.
An analysis of the cytological features of bronchoalveolar lavage samples can provide useful information for the management of coronavirus disease 2019 patients in the intensive care unit.
Databáze: OpenAIRE
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