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Utility of bronchoalveolar lavage for COVID-19: a perspective from the Dragon consortium.
  • +29
  • Sara Tomassetti,
  • Luca Ciani,
  • Valentina Luzzi,
  • Leonardo Gori,
  • Leonardo Giuntoli,
  • Federico Lavorini,
  • Venerino Poletti,
  • Claudia Ravaglia,
  • Alfons Torrego,
  • Fabien Maldonado,
  • Robert Lentz,
  • Francesco Annunziato,
  • Laura Maggi,
  • Gian Maria Rossolini,
  • Simona Pollini,
  • Ombretta Para,
  • Greta Ciurleo,
  • Alessandro Casini,
  • Laura Rasero,
  • Alessandro Bartoloni,
  • Michele Spinicci,
  • Mohammed Munavvar,
  • Stefano Gasparini,
  • Camilla Comin,
  • Marco Matucci Cerinic,
  • Anna Peired,
  • Monique Henket,
  • Ernst Benoit,
  • Renaud Louis,
  • Jean-Louis Corhay,
  • Cosimo Nardi,
  • Julien Guiot
Sara Tomassetti
AOU Careggi

Corresponding Author:[email protected]

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Luca Ciani
AOU Careggi
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Valentina Luzzi
AOU Careggi
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Leonardo Gori
AOU Careggi
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Leonardo Giuntoli
AOU Careggi
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Federico Lavorini
AOU Careggi
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Venerino Poletti
Ospedale Morgagni-Pierantoni
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Claudia Ravaglia
Ospedale Morgagni-Pierantoni
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Alfons Torrego
Hospital de la Santa Creu i Sant Pau
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Fabien Maldonado
Vanderbilt University Medical Center
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Robert Lentz
Vanderbilt University Medical Center
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Francesco Annunziato
University of Florence
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Laura Maggi
University of Florence
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Gian Maria Rossolini
University of Florence
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Simona Pollini
University of Florence
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Ombretta Para
AOU Careggi
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Greta Ciurleo
AOU Careggi
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Alessandro Casini
AOU Careggi
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Laura Rasero
University of Florence
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Alessandro Bartoloni
AOU Careggi
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Michele Spinicci
AOU Careggi
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Mohammed Munavvar
Lancashire Teaching Hospitals NHS Foundation Trust
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Stefano Gasparini
Polytechnic University of Marche
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Camilla Comin
University of Florence
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Marco Matucci Cerinic
University of Florence
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Anna Peired
University of Florence
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Monique Henket
CHU de Liège
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Ernst Benoit
CHU de Liege - Hopital du Sart Tilman
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Renaud Louis
CHU de Liege - Hospital Sart Tilman
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Jean-Louis Corhay
CHU de Liege - Hopital du Sart Tilman
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Cosimo Nardi
University of Florence
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Julien Guiot
CHU de Liege - Hopital du Sart Tilman
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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 in supporting alternative diagnosis, and can change management decisions in up to two-third 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 the understanding of 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 health care 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 with great potential for research.