tetano
Editor, Senior Moderator
BMC Infect Dis
. 2023 Mar 7;23(1):137.
doi: 10.1186/s12879-023-08104-3.
Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case-control study
Se Ju Lee[SUP] 1 2 [/SUP], Jinnam Kim[SUP] 1 [/SUP], Ki Hyun Lee[SUP] 1 [/SUP], Jung Ah Lee[SUP] 1 [/SUP], Chang Hyup Kim[SUP] 1 [/SUP], Su Hwan Lee[SUP] 3 [/SUP], Byung Jo Park[SUP] 4 [/SUP], Jung Ho Kim[SUP] 1 [/SUP], Jin Young Ahn[SUP] 1 [/SUP], Su Jin Jeong[SUP] 1 [/SUP], Nam Su Ku[SUP] 1 [/SUP], Joon-Sup Yeom[SUP] 1 [/SUP], Jun Yong Choi[SUP] 5 [/SUP]
Affiliations
Abstract
Background: During the novel coronavirus disease-2019 pandemic, a considerable number of pneumothorax (PNX)/pneumomediastinum (PNM) associated with COVID-19 have been reported, and the incidence is higher in critically ill patients. Despite using a protective ventilation strategy, PNX/PNM still occurs in patients on invasive mechanical ventilation (IMV). This matched case-control study aims to identify the risk factors and clinical characteristics of PNX/PNM in COVID-19.
Methods: This retrospective study enrolled adult patients with COVID-19, admitted to a critical care unit from March 1, 2020, to January 31, 2022. COVID-19 patients with PNX/PNM were compared, in a 1-2 ratio, to COVID-19 patients without PNX/PNM, matched for age, gender, and worst National Institute of Allergy and Infectious Diseases ordinal scale. Conditional logistic regression analysis was performed to assess the risk factors for PNX/PNM in COVID-19.
Results: 427 patients with COVID-19 were admitted during the period, and 24 patients were diagnosed with PNX/PNM. Body mass index (BMI) was significantly lower in the case group (22.8 kg/m[SUP]2[/SUP] and 24.7 kg/m[SUP]2[/SUP]; P = 0.048). BMI was statistically significant risk factor for PNX/PNM in univariate conditional logistic regression analysis [odds ratio (OR), 0.85; confidence interval (CI), 0.72-0.996; P = 0.044]. For patients on IMV support, univariate conditional logistic regression analysis showed the statistical significance of the duration from symptom onset to intubation (OR, 1.14; CI, 1.006-1.293; P = 0.041).
Conclusions: Higher BMI tended to show a protective effect against PNX/PNM due to COVID-19 and delayed application of IMV might be a contributive factor for this complication.
Keywords: COVID-19; Pneumomediastinum; Pneumothorax; Risk factors.
. 2023 Mar 7;23(1):137.
doi: 10.1186/s12879-023-08104-3.
Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case-control study
Se Ju Lee[SUP] 1 2 [/SUP], Jinnam Kim[SUP] 1 [/SUP], Ki Hyun Lee[SUP] 1 [/SUP], Jung Ah Lee[SUP] 1 [/SUP], Chang Hyup Kim[SUP] 1 [/SUP], Su Hwan Lee[SUP] 3 [/SUP], Byung Jo Park[SUP] 4 [/SUP], Jung Ho Kim[SUP] 1 [/SUP], Jin Young Ahn[SUP] 1 [/SUP], Su Jin Jeong[SUP] 1 [/SUP], Nam Su Ku[SUP] 1 [/SUP], Joon-Sup Yeom[SUP] 1 [/SUP], Jun Yong Choi[SUP] 5 [/SUP]
Affiliations
- PMID: 36882735
- DOI: 10.1186/s12879-023-08104-3
Abstract
Background: During the novel coronavirus disease-2019 pandemic, a considerable number of pneumothorax (PNX)/pneumomediastinum (PNM) associated with COVID-19 have been reported, and the incidence is higher in critically ill patients. Despite using a protective ventilation strategy, PNX/PNM still occurs in patients on invasive mechanical ventilation (IMV). This matched case-control study aims to identify the risk factors and clinical characteristics of PNX/PNM in COVID-19.
Methods: This retrospective study enrolled adult patients with COVID-19, admitted to a critical care unit from March 1, 2020, to January 31, 2022. COVID-19 patients with PNX/PNM were compared, in a 1-2 ratio, to COVID-19 patients without PNX/PNM, matched for age, gender, and worst National Institute of Allergy and Infectious Diseases ordinal scale. Conditional logistic regression analysis was performed to assess the risk factors for PNX/PNM in COVID-19.
Results: 427 patients with COVID-19 were admitted during the period, and 24 patients were diagnosed with PNX/PNM. Body mass index (BMI) was significantly lower in the case group (22.8 kg/m[SUP]2[/SUP] and 24.7 kg/m[SUP]2[/SUP]; P = 0.048). BMI was statistically significant risk factor for PNX/PNM in univariate conditional logistic regression analysis [odds ratio (OR), 0.85; confidence interval (CI), 0.72-0.996; P = 0.044]. For patients on IMV support, univariate conditional logistic regression analysis showed the statistical significance of the duration from symptom onset to intubation (OR, 1.14; CI, 1.006-1.293; P = 0.041).
Conclusions: Higher BMI tended to show a protective effect against PNX/PNM due to COVID-19 and delayed application of IMV might be a contributive factor for this complication.
Keywords: COVID-19; Pneumomediastinum; Pneumothorax; Risk factors.