Kleymann Janina, Brückmann Sascha, Langner Simona, Koschel Dirk, Kolditz Martin
Medical Department I, Division of Pneumology, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
East German Lung Center Dresden - Coswig, Dresden - Coswig, Germany.
BMC Pulm Med. 2024 Dec 23;24(1):631. doi: 10.1186/s12890-024-03449-0.
The role of lung biopsy for evaluation of persistent chest radiographic abnormalities including secondary organizing pneumonia (OP) in COVID-19 remains uncertain. This study aimed to evaluate the diagnostic value of trans-bronchial forceps biopsy (TBFB) in patients with persistent lung abnormalities on thoracic computed tomography (CT) scan following SARS-CoV-2 infection with particular focus on cases with OP and immunocompromised (IC) patients.
Descriptive retrospective single center analysis of all TBFB performed for diffuse lung parenchymal changes after COVID-19 03-2020 to 06-2023.
Twenty seven consecutive TBFB including 23 in IC patients resulted in 100% samples with alveolar tissue showing a high frequency of 12/27 (44%) histological pattern of OP. Steroids were used in 21/27 patients (78%) including 11/12 (92%) with OP. Clinical outcome at discharge was favorable in 89% (92% with OP).
TBFB contributes to the diagnosis of diffuse parenchymal lung abnormalities in the context of COVID-19 including a frequent OP pattern particularly in IC patients. Larger studies are necessary to confirm our data and elucidate on the optimal steroid treatment modality.
Clinical trial number: not applicable. The study was approved by the Ethics Committee of the University Medicine Carl Gustav Carus, TU Dresden (BO-EK-309072023). Waiver of informed consent was granted because of the retrospective nature of the study.
肺活检在评估新型冠状病毒肺炎（COVID-19）中持续性胸部影像学异常（包括继发性机化性肺炎（OP））方面的作用仍不明确。本研究旨在评估经支气管钳取活检（TBFB）对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染后胸部计算机断层扫描（CT）显示持续性肺部异常患者的诊断价值，特别关注OP病例和免疫功能低下（IC）患者。
对2020年3月至2023年6月COVID-19后因弥漫性肺实质改变而进行的所有TBFB进行描述性回顾性单中心分析。
连续27例TBFB，其中23例为IC患者，100%的样本显示肺泡组织，OP组织学模式的发生率较高，为12/27（44%）。21/27例（78%）患者使用了类固醇，其中11/12例（92%）OP患者使用了类固醇。出院时临床结局良好的患者占89%（OP患者为92%）。
TBFB有助于诊断COVID-19背景下的弥漫性肺实质异常，包括常见的OP模式，尤其是在IC患者中。需要更大规模的研究来证实我们的数据，并阐明最佳的类固醇治疗方式。
临床试验编号：不适用。本研究经德累斯顿工业大学卡尔·古斯塔夫·卡鲁斯大学医学伦理委员会批准（BO-EK-309072023）。由于本研究的回顾性性质，豁免了知情同意。
