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Updated: Sep 19, 2025

Bronchoalveolar Lavage BAL for Research; Obtaining Adequate Sample Yield
Published on: March 24, 2014
[The impact of bronchoalveolar lavage in patients intubated for COVID-19]
L A Pernaut1, F Wallyn1, X Dhalluin1
1Service d'endoscopie respiratoire, clinique de pneumologie, institut cœur poumon, CHU de Lille, boulevard du Pr Jules-Leclerc, Lille, France.
Introduction:
Pulmonary infections complicating COVID-19 are common. The aim of this study was to describe the main findings regarding the impact of bronchoalveolar lavage (BAL) in severe COVID-19 patients in intensive care.
Methods:
Retrospective observational study including all BALs performed in our institution between September 2020 and May 2021 in patients intubated for COVID-19.
Results:
Two hundred and fifty-eight BALs carried out in 195 patients were analyzed; 12.9% of patients had an early bacterial infection, mainly in contexts of immunodeficiency (ID) and/or chronic respiratory disease (CRD). A bacterial ventilation-acquired lower respiratory tract infection (VA-LRTI) was diagnosed in 29.6% of patients. COVID-19-associated pulmonary aspergillosis (CAPA), according to the ECMM/ISHAM criteria, was found in 7.8%, particularly in cases of ID and/or CRD. CMV and/or HSV-1 PCR were positive in nearly one-third of the BALs, of which 43.8% were treated. The histopathological results had no obvious therapeutic consequences.
Conclusion:
Early bacterial pulmonary infections and CAPA appear more frequent in cases of ID and/or CRD, and should be investigated in the affected patients. Incidence of VA-LRTI, which is more frequent in cases of prolonged ventilation, does not differ based on the underlying condition. The benefit of virology is uncertain. Cytological examination of BAL appears to have a limited therapeutic impact.
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