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Background <p>COVID-19 pandemic is caused by SARS-CoV-2 and led to significant morbidity and mortality. COVID-19 infection is usually complicated by bacterial and fungal infections and lung fibrosis. The causative agents and pathophysiological mechanisms of post-COVID pulmonary complications are under estimated. Bronchoalveolar lavage (BAL) is a diagnostic tool for assessment of lung diseases, but its role in post-COVID-19 patients remains underexplored. This study aimed to assess the cellular patterns and microbial isolates of BAL in post-acute COVID-19 patients.</p> Methods <p>A prospective observational cross-sectional study was conducted on 30 COVID-19 survivors at the Interventional Pulmonology Unit of Chest Medicine Department, Mansoura University Hospitals, Egypt, between January 2021 and December 2022. The revision of the patient’s medical records during acute illness, along with the detection of persistent symptoms and the degree of pulmonary affection using a CT severity score ranging from 0 (no involvement) to 25 (maximum involvement), was done for all patients before bronchoscopy. BAL was done, and the retrieved fluid was analyzed for bacterial, fungal, and mycobacterial cultures and cellular patterns. The study population was divided into two groups based on the results of microbial cultures.</p> Results <p>The mean age of participants was 56.2 years, with 63.3% males and 36.7% females. Comorbidities were present in 63.3% of patients, with diabetes mellitus being the most common (40%). Fatigue and dyspnea were the most reported symptoms (76.7%). Imaging findings revealed fibrotic bands in 70% and cavitation in 50% of patients. BAL analysis showed a neutrophilic cellular pattern in 93.3% of cases. Bacterial cultures were positive in 63.3% of patients, with <i>Klebsiella pneumoniae</i> being the most commonly isolated pathogen (23.3%). Fungal cultures were positive in 13.3% of cases.</p> Conclusion <p>BAL is a valuable tool for assessing post-COVID-19 persistent pulmonary infiltrates and detecting secondary infections by isolating the causative pathogens. The high prevalence of neutrophilic inflammation and bacterial secondary infections highlights the need for specific therapy in post-COVID-19 patients with persistent pulmonary symptoms (ClinicalTrials.gov (NCT 06022198)).</p>

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Microbial isolates and cellular pattern of bronchoalveolar lavage in COVID-19 survivors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月17日

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  • Marwa Salah Ghanem,
  • Tamer Ali Elhadidy,
  • Dalia Abdellateif Abdelghany,
  • Ahmed E. Eladl,
  • Metwaly Ibrahim Mortada,
  • Mohammad Khairy El-Badrawy

摘要

Background

COVID-19 pandemic is caused by SARS-CoV-2 and led to significant morbidity and mortality. COVID-19 infection is usually complicated by bacterial and fungal infections and lung fibrosis. The causative agents and pathophysiological mechanisms of post-COVID pulmonary complications are under estimated. Bronchoalveolar lavage (BAL) is a diagnostic tool for assessment of lung diseases, but its role in post-COVID-19 patients remains underexplored. This study aimed to assess the cellular patterns and microbial isolates of BAL in post-acute COVID-19 patients.

Methods

A prospective observational cross-sectional study was conducted on 30 COVID-19 survivors at the Interventional Pulmonology Unit of Chest Medicine Department, Mansoura University Hospitals, Egypt, between January 2021 and December 2022. The revision of the patient’s medical records during acute illness, along with the detection of persistent symptoms and the degree of pulmonary affection using a CT severity score ranging from 0 (no involvement) to 25 (maximum involvement), was done for all patients before bronchoscopy. BAL was done, and the retrieved fluid was analyzed for bacterial, fungal, and mycobacterial cultures and cellular patterns. The study population was divided into two groups based on the results of microbial cultures.

Results

The mean age of participants was 56.2 years, with 63.3% males and 36.7% females. Comorbidities were present in 63.3% of patients, with diabetes mellitus being the most common (40%). Fatigue and dyspnea were the most reported symptoms (76.7%). Imaging findings revealed fibrotic bands in 70% and cavitation in 50% of patients. BAL analysis showed a neutrophilic cellular pattern in 93.3% of cases. Bacterial cultures were positive in 63.3% of patients, with Klebsiella pneumoniae being the most commonly isolated pathogen (23.3%). Fungal cultures were positive in 13.3% of cases.

Conclusion

BAL is a valuable tool for assessing post-COVID-19 persistent pulmonary infiltrates and detecting secondary infections by isolating the causative pathogens. The high prevalence of neutrophilic inflammation and bacterial secondary infections highlights the need for specific therapy in post-COVID-19 patients with persistent pulmonary symptoms (ClinicalTrials.gov (NCT 06022198)).