Bronchoscopy in the post-acute phase of COVID-19: an observational study

• Published in: BMC pulmonary medicine Vol. 23; no. 1; p. 178
• Main Authors: Mondoni, Michele, Rinaldo, Rocco Francesco, Cefalo, Jacopo, Saderi, Laura, Vigo, Beatrice, Carlucci, Paolo, Tirelli, Claudio, Cariboni, Umberto, Santus, Pierachille, Centanni, Stefano, Sotgiu, Giovanni
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22-05-2023; BioMed Central; BMC
• Subjects: Bronchoscopy; Bronchoscopy - methods; Complications; COVID-19; COVID-19 - complications; COVID-19 sequelae; Disease Progression; Endoscopy; Female; Hospitalization; Humans; Infections; Intubation; Long COVID; Lung cancer; Male; Medical imaging; Observational studies; Ostomy; Patient outcomes; Patients; Pneumonia; Pulmonology; Retrospective Studies; Severe acute respiratory syndrome coronavirus 2; Trachea; Tracheal stenosis; Tracheal Stenosis - etiology; Tracheostomy; Bronchoscopy; Tracheotomy; Viral infections; Italy; Tracheal stenosis; COVID-19 sequelae; Long COVID; Tracheostomy; Bronchoscopy; Lung cancer
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-023-02477-6

Bronchoscopy is a useful technique adopted in the management of patients with COVID-19. 10-40% of COVID-19 survivors experience persistent symptoms. A comprehensive description of the utility and safety of bronchoscopy in the management of patients with COVID-19 sequelae is lacking. The aim of the study was to evaluate the role of bronchoscopy in patients with suspected post-acute sequelae of COVID-19.
An observational, retrospective study was carried out in Italy. Patients requiring bronchoscopy for suspected COVID-19 sequelae were enrolled.
45 (21, 46.7%, female) patients were recruited. Bronchoscopy was more frequently indicated for patients with a previous critical disease. The most frequent indications were tracheal complications, mostly performed in patients who were hospitalized during the acute phase than treated at home (14, 48.3% VS. 1, 6.3%; p-value: 0.007) and persistent parenchymal infiltrates, more frequent in those treated at home (9, 56.3% VS. 5, 17.2%; p-value: 0.008). 3 (6.6%) patients after the first bronchoscopy required higher oxygen flow. Four patients were diagnosed with lung cancer.
Bronchoscopy is a useful and safe technique in patients with suspected post-acute sequelae of COVID-19. The severity of acute disease plays a role in the rate and indications of bronchoscopy. Endoscopic procedures were mostly performed for tracheal complications in critical, hospitalized patients and for persistent lung parenchymal infiltrates in mild-moderate infections treated at home.