Trans-bronchial forceps biopsy for COVID-19 related diffuse parenchymal lung abnormalities

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Persistent lung abnormalities after COVID-19 require further diagnostic evaluation.
• The utility of lung biopsy in these cases, particularly for organizing pneumonia (OP), is not well-established.
• Immunocompromised (IC) patients present unique challenges in post-COVID-19 lung disease management.

Purpose of the Study:

• To assess the diagnostic value of trans-bronchial forceps biopsy (TBFB) for persistent lung abnormalities post-SARS-CoV-2 infection.
• To specifically evaluate TBFB's role in identifying organizing pneumonia (OP) patterns.
• To analyze TBFB utility in immunocompromised (IC) patients with post-COVID-19 lung abnormalities.

Main Methods:

• A descriptive retrospective analysis of TBFB procedures performed for diffuse lung changes after COVID-19.
• Data collected from March 2020 to June 2023 at a single center.
• Focus on patients with persistent thoracic CT abnormalities post-SARS-CoV-2 infection.

Main Results:

• Twenty-seven TBFB procedures were analyzed, with 23 in IC patients.
• A high frequency of organizing pneumonia (OP) was observed in 44% (12/27) of samples.
• Favorable clinical outcomes at discharge were noted in 89% of patients, including 92% with OP, often treated with steroids.

Conclusions:

• TBFB is valuable for diagnosing diffuse lung abnormalities following COVID-19, frequently identifying OP, especially in IC patients.
• The findings suggest TBFB contributes significantly to patient management in this cohort.
• Further large-scale studies are needed to confirm these results and optimize steroid treatment strategies.