The Role of Bronchoscopy in the Diagnosis and Management of Patients with SARS-Cov-2 Infection

Abstract

Bronchoscopy has several major diagnostic and therapeutic indications in pulmonology. However, it is an aerosol-generating procedure that places healthcare providers at an increased risk of infection. Now more than ever, during the spread of the coronavirus disease 2019 (COVID-19) pandemic, the infectious risk during bronchoscopy is significantly raised, and for this reason its role in diagnostic management is debated. In this review, we summarized current evidence regarding the indications for bronchoscopy and the measures that should be applied to decrease risk exposure. Indeed, seeing the long-lasting period of the pandemic, resuming standard of care for all patients is required.

The Additional Value of Lower Respiratory Tract Sampling in the Diagnosis of COVID-19: A Real-Life Observational Study

“…Our data suggest that COVID-19 is a multimodal diagnosis which should not only rely on a single test but rather on a panel of tests, including CT scans and LRT samples, especially when a CT scan is consistent with COVID-19 pneumonia, and less invasive tests cannot be conclusive. The role of bronchoscopy in the context of COVID-19 is still being debated as thoroughly presented in a recent review [ 44 ]. Multidisciplinary discussion, including at least radiologists and pulmonologists, is advisable in more complex cases.…”

“…It must be underlined that SARS-CoV-2 diagnosis is not only necessary in order to prevent the spread of the infection but also to access treatment (e.g., participation in clinical trials) and assure safety before undertaking immunosuppressive or chemotherapy treatment. Other applications of bronchoscopy in suspect cases can include differential diagnosis with other infectious diseases and the clearance of mucous secretions and plugs [ 26 , 44 ].…”