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Objective: evaluate the utility of bronchoalveolar lavage(BAL)to detect the etiology of infectious complications in patients with severe SARS-COV2 pneumonia Methods: retrospective observational study of hospitalized for SARSCOV2 pneumonia in Pneumology or ICU service of our hospital from 1/3/2020 to 31/12/2020.Divided in 2 groups:BAL +/- Results: 1854 were hospitalized for SARS-COV2 pneumonia, BAL was performed in 80(4.3%).76%(61)were men, mean age 59.8 years and 68% had comorbidities.95% needed invasive mechanical ventilation(IMV).BAL microbiology was positive in 32 patients(40%).Table1:general characteristics of patients and differences depending on the result of BAL.Isolated microorganisms are detailed in figure 1 38(47.5%)of the patients died. In hospital mortality was significantly higher in men,(62%vs21%; p=0.008) and in older patients, mean age was of 62,8 years in dead and 57,1 years in alive patients (p=0,02) Conclusions: BAL was realized in 4.3% of the patients hospitalized for SARS-COV-2 pneumonia, 95% were in ICU patients with IMV BAL microbiology was positive in 40% Bronchoscopy findings did not impact on in-hospital course

Introduction: The aim was to evaluate the clinical characteristics and evolution of community acquired pneumonia with associated paraneumonic pleural effusion(PE-CAP). Methods: Prospective observational study of all immunocompetent patients hospitalized for PE-CAP in our Pulmonology Service between 2005 and 2019.We considered PE-CAP when compatible radiology.Pleural effusion (PE) was classified as complicated based on its biochemical and/or radiological characteristics.Empyema criteria:macroscopic pus or germs in microbiological analysis of pleural fluid (PF). Results: 3417 patients, of which 221(6.5%) had PE. PF analysis was performed in 158 patients, of which in 134 cases the microbiology was negative and in 24 positive (9 Streptococcus spp.,8 S.pneumoniae,3 S.aureus,3 S.viridans,1 Eikinella corrodens). Bacteremia was observed in 34(15.4%) patients with PE: 31 cases S.pneumoniae,2 S.pyogenes and 1 S. viridans. Positive blood culture and positive microbiology of PF were observed in 4 patients (3 S.pneumoniae and 1 S.viridans). Conclusions: 6.5% of our patients had PE-CAP but only 1.9% complicated PE. Microbiological diagnosis was obtained in 15% of analyzed PF, and S. pneumoniae was the most frequent microorganism. Patients with CAP and PE were younger, less frequently vaccinated and with less comorbidities.They had more bacteremia, therapeutic failure,longer hospital stay,and later clinical stability, although they had similar mortality.