Study: BAL samples that reveal high fungal and bacterial loads in COVID patients with ARDS are indicators of poor outcomes.

Patient Safety

BAL Findings Can Help Predict Outcomes In COVID Patients With ARDS

“Disentangling this web of microbial, pathogen and host dynamics is the only way we will be able to risk-stratify patients and identify treatable traits."

High bacterial and fungal burden detected in bronchoalveolar lavage (BAL) samples of COVID-19 patients with acute respiratory distress (ARDS) has been linked to higher deaths.

The study, out of Amsterdam, was designed to assess the relationship between lung microbiota and clinical outcomes of COVID-19-related ARDS.

Published in the American Journal of Respiratory and Critical Care Medicine, the study included 114 mechanically ventilated patients with COVID-19 and ARDS who underwent bronchoscopy with BAL.

Researchers found that those patients with the highest bacterial and fungal burdens were less likely to be extubated and to survive than those with lower levels. More than half of the patients in the study died.

“Our findings confirm the importance of the lung microbiome in ARDS and COVID-19 and highlight the significance of the — often overlooked — pulmonary fungal burden in critically ill patients,” Dr. Robert F.J. Kullberg and others wrote.

The study’s endpoint was defined as successful extubation within 60 days after intubation.

The authors say this study validates earlier research which showed increased bacterial burden to be associated with higher mortality but is the first to link a higher fungal burden with high fatality in COVID patients with ARDS.

“In the context of other investigations on lower airway samples from critically ill patients with COVID-19, these results solidify the notion that it is not just uncontrollable SARS-CoV-2 infection that kills patients with COVID-19, though that’s likely one big part of it,” wrote authors of a related editorial.

More research is needed, they added.

“Disentangling this web of microbial, pathogen and host dynamics is the only way we will be able to risk-stratify patients and identify treatable traits,” the authors of the editorial wrote.

More Pulmonology Articles
Are You Following The Right Pulmonology Influencers?
Best Practices
For a broader look at social media in the medical world, the Healthcare Hashtag Project describes itself as a platform that connects doctors, caregivers, patient advocates and other providers to relevant conversations and communities.
Healthcare Shortage Means High Caseloads for Physicians
Public Health
A ranking of specialties by caseload answers the question of which physicians are responsible for the highest number of patients. Wonder where your specialty comes in?
More From Single-Use Endoscopy
A look at what

Best Practices

From progress in the gender wage gap to new roles for physician assistants, the otolaryngology space is a busy place.

Study: Single-Use Duodenoscopes Are Capable of High Completion Rates in ERCP

Preventing Infection

Research presented recently at ACG 2023 proves this, as well as low adverse event rates from single-use models.

The personal hygiene and dress code of sterile processors have the power to make a difference in patient safety.

Patient Safety

When it comes to keeping patients safe, personal hygiene and the dress code maintained by sterile processors is essential.