Eid, K.

Abstract Rationale: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant in the alveoli, primarily seen in autoimmune PAP (aPAP), which accounts for over 90% of cases. The COVID-19 pandemic has highlighted the potential for viral infections to exacerbate or induce PAP, complicating diagnosis and treatment. Objective: This study aims to provide updated clinical and demographic characteristics of patients with pulmonary alveolar proteinosis (PAP) and to analyze trends in the use of whole lung lavage before the COVID-19 pandemic, as well as assess the impact of the pandemic on WLL utilization. Methods: Using data from the National Inpatient Sample from 2017 to 2021, the authors identified PAP, other diagnoses, and procedures. using the respective ICD-10 codes. Statistical analysis was performed on the trends of whole lung lavage and other outcomes across the five years. Results: A total of 3,030 hospitalized PAP patients were included in the study, with demographic and clinical characteristics reported for the cohort. Although the use of WLL increased from 11.55% pre-pandemic to 14.67% during the pandemic, this difference was not statistically significant. However, there was a significant rise in the incidence of acute respiratory failure during the pandemic (35.7% vs. 45.78%, p = 0.02). While transbronchial lung biopsies increased and open lung biopsies declined, these trends were not statistically significant. Conclusion: In recent years, despite a decline in the use of WLL for treating PAP and open lung biopsies for diagnosis, the rates have risen due to the impact of the COVID-19 pandemic.