Author:
Dentone Chiara,Vena Antonio,Loconte Maurizio,Grillo Federica,Brunetti Iole,Barisione Emanuela,Tedone Elisabetta,Mora Sara,Di Biagio Antonio,Orsi Andrea,De Maria Andrea,Nicolini Laura,Ball Lorenzo,Giacobbe Daniele Roberto,Magnasco Laura,Delfino Emanuele,Mastracci Luca,Mangerini Rosa,Taramasso Lucia,Sepulcri Chiara,Pincino Rachele,Bavastro Martina,Cerchiaro Matteo,Mikulska Malgorzata,Bruzzone Bianca,Icardi Giancarlo,Frisoni Paolo,Gratarola Angelo,Patroniti Nicolò,Pelosi Paolo,Bassetti Matteo
Abstract
Abstract
Background
The 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 methods
Patients 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.
Results
Sixty-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).
Conclusions
In 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.
Publisher
Springer Science and Business Media LLC
Cited by
23 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献