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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: Hypersensitivity pneumonitis (HP) in a prevalent disease in the ILD Units, and often a diagnostic challenge. The objective is to analyze the prevalence and main epidemiological characteristics of HP patients attended at our hospital in the last 5 years. Material & Methods: Observational and descriptive study in which all ILD patients were included, from Jan 2014 - Oct 2019. We have collected epidemiological, clinical and functional data. Results: 63 HP patients from 485 ILD patients 12.9%, 3rd cause after IPF and secondary to CTD. 54% males, mean age 68.11 y/o. 23.8% are acute/subacute, 76.2% chronic. At diagnosis, 28.6% presented dyspnea 0, 1 30.2%, 2 39.7%, 3 1.6%, nobody grade 4. Mean functional tests at diagnosis: FVC 80.8%, FEV1 84.7%, DCO 58; 6MWT distance 499 meters, initial satO2 95%, final satO2 88%. 68.3% live in urban environment, 31.7% in rural one. Exposure was clinically identified in half of the cases: birds 24.2%, farmhouse environment 9.7%, humidity at home 6.4%, occupational exposure 4.8%, pillow, drugs and sculpture material; unknown in 31 cases. Radiological pattern was predominantly fibrotic in 18 patients 28.6% and inflammatory in 45 71.4%. Anatomopathological sample was obtained in 26 patients 41.3%, 4 by surgical biopsy 6.3%, 22 cryobiopsy 34.9%; no biopsy in 58.7%. BAL was performed in 61.9% with an average lymphocyte count of 16.34% (> 20% in 9 patients 25%). Five patients died 7.9% and two patients have been transplanted in these 5 years. Conclusions: HP is the 3rd cause of ILD in our population, 13% of all ILDs. 3/4 of the patients present chronic forms. Only 41% have been biopsied. In half of the cases the exposure could not be identified

Introduction: Forced spirometry (FS) is essential for diagnosis and control of respiratory diseases. The aim is to analyze demographic, clinical and spirometric variables by age groups. Method: Retrospective study including all high quality FS (according to clinical guidelines) performed in 140 primary care centers from Sep 2011 to Feb 2019. Variables were divided by age ranges (≤14, 14-65, 65-80 and >80 years). Results: 56,515 FS were performed: 6,149 in ≤14 years (y), 36,732 in 14-65y, 11,662 in 65-80y and 1,972 in >80y. Asthma was the main previous diagnosis in the 0-65y group and COPD in the 65-95y group. In 14-65y group most of the tests are done for diagnosis and in the rest of ranges for control. In the FS performed for diagnosis, positive Post-Bronchodilator test (PBD) was detected in 2.4% of patients ≤14y, 22.1% in 14-65y, 17.4% in 65-80y and 11.7% in >80y. FEV1/FVC PBD 80y (45.3% smoking history). Tables 1 and 2 show spirometric data classified by age groups and subclassified by previous diagnoses of asthma and COPD. Conclusions: The main pre-diagnosis 80y. Considerable number of patients had previous COPD diagnosed without obstruction in PDB spirometry.

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.