Whole Pulmonary Lavage: Treating Pulmonary Alveolar Proteinosis At The
Time of COVID Pandemic
Abstract
Pulmonary alveolar proteinosis (PAP) is a rare syndrome due to increased
production or decreased clearance of surfactant in alveoli and terminal
bronchi that cause hypoxemic respiratory insufficiency. Here we present
a patient with past medical history of PAP whose disease was exacerbated
by superimposed COVID-19 pneumonia. He underwent whole pulmonary lavage
(WPL). Evaluation of the viral count of the first and the last lavage of
the left lung showed viral load in the alveolar space dropped by
approximately 10-folds, however the magnitude of the viral load was
substantial in both lavage samples. Whole pulmonary lavage may be used
as a treatment option on patients with COVID pneumonia superimposed on a
pulmonary alveolar proteinosis (PAP) exacerbation.