Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. We report here what may be, to the best of our knowledge, the first videoendoscopic...

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Autores principales:	Vincent Jounieaux, Damien Basille, Bénédicte Toublanc, Claire Andrejak, Daniel Oscar Rodenstein, Yazine Mahjoub
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	SARS-CoV-2 bronchovideoscopy NBI (narrow band imaging) intrapulmonary shunt AVDS Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/423ea318ccb44984b17df7f6cdf6b49b
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spelling	oai:doaj.org-article:423ea318ccb44984b17df7f6cdf6b49b2021-12-01T15:56:31ZCase Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-192296-858X10.3389/fmed.2021.710992https://doaj.org/article/423ea318ccb44984b17df7f6cdf6b49b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.710992/fullhttps://doaj.org/toc/2296-858XBackground: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. We report here what may be, to the best of our knowledge, the first videoendoscopic descriptions of an hypervascularization of the bronchial mucosa in two patients hospitalized for coronavirus disease 2019 (COVID-19) pneumonia.Cases Presentation: Two patients, 27- and 37-year-old, were addressed to our Pneumology department for suspicion of COVID-19 pneumonia. Their symptoms (fever, dry cough, and dyspnoea), associated to pulmonary ground glass opacities on thoracic CT, were highly suggestive of a COVID-19 disease despite repeated negative pharyngeal swabs RT-PCR. In both patients, bronchoscopy examination using white light was unremarkable but NBI bronchoscopy revealed a diffuse hypervascularization of the mucosa from the trachea to the sub-segmental bronchi, associated with dilated submucosal vessels. RT-PCR performed in bronchoalveolar lavage (BAL) confirmed the presence of Sars-CoV-2.Conclusions: These two case reports highlight the crucial importance of the vascular component of the viral disease. We suggest that such bronchial hypervascularization with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterizes the COVID-19 related Acute Vascular Distress Syndrome (AVDS). The presence of diffuse bronchial hypervascularization in the context of COVID-19 pandemic should prompt the search for Sars-CoV-2 in BAL samples.Vincent JounieauxDamien BasilleBénédicte ToublancClaire AndrejakDaniel Oscar RodensteinYazine MahjoubFrontiers Media S.A.articleSARS-CoV-2bronchovideoscopyNBI (narrow band imaging)intrapulmonary shuntAVDSMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	SARS-CoV-2 bronchovideoscopy NBI (narrow band imaging) intrapulmonary shunt AVDS Medicine (General) R5-920
spellingShingle	SARS-CoV-2 bronchovideoscopy NBI (narrow band imaging) intrapulmonary shunt AVDS Medicine (General) R5-920 Vincent Jounieaux Damien Basille Bénédicte Toublanc Claire Andrejak Daniel Oscar Rodenstein Yazine Mahjoub Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19
description	Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. We report here what may be, to the best of our knowledge, the first videoendoscopic descriptions of an hypervascularization of the bronchial mucosa in two patients hospitalized for coronavirus disease 2019 (COVID-19) pneumonia.Cases Presentation: Two patients, 27- and 37-year-old, were addressed to our Pneumology department for suspicion of COVID-19 pneumonia. Their symptoms (fever, dry cough, and dyspnoea), associated to pulmonary ground glass opacities on thoracic CT, were highly suggestive of a COVID-19 disease despite repeated negative pharyngeal swabs RT-PCR. In both patients, bronchoscopy examination using white light was unremarkable but NBI bronchoscopy revealed a diffuse hypervascularization of the mucosa from the trachea to the sub-segmental bronchi, associated with dilated submucosal vessels. RT-PCR performed in bronchoalveolar lavage (BAL) confirmed the presence of Sars-CoV-2.Conclusions: These two case reports highlight the crucial importance of the vascular component of the viral disease. We suggest that such bronchial hypervascularization with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterizes the COVID-19 related Acute Vascular Distress Syndrome (AVDS). The presence of diffuse bronchial hypervascularization in the context of COVID-19 pandemic should prompt the search for Sars-CoV-2 in BAL samples.
format	article
author	Vincent Jounieaux Damien Basille Bénédicte Toublanc Claire Andrejak Daniel Oscar Rodenstein Yazine Mahjoub
author_facet	Vincent Jounieaux Damien Basille Bénédicte Toublanc Claire Andrejak Daniel Oscar Rodenstein Yazine Mahjoub
author_sort	Vincent Jounieaux
title	Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19
title_short	Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19
title_full	Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19
title_fullStr	Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19
title_full_unstemmed	Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19
title_sort	case reports: bronchial mucosal vasculature is also involved in the acute vascular distress syndrome of covid-19
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/423ea318ccb44984b17df7f6cdf6b49b
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Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19

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