tetano
Editor, Senior Moderator
J Thorac Dis
. 2024 Jun 30;16(6):3593-3605.
doi: 10.21037/jtd-23-1454. Epub 2024 Jun 5. Prevalence and patient risk factors for pneumothorax in COVID-19 and in influenza pneumonia: a nationwide comparative analysis
Sanya Chandna[SUP] 1 [/SUP], Kavin Raj[SUP] 2 [/SUP], Ankit Agrawal[SUP] 1 [/SUP], Saumya Nanda[SUP] 3 [/SUP], Keerthana Jyotheeswara Pillai[SUP] 4 [/SUP], Umesh Bhagat[SUP] 1 [/SUP], Suryansh Bajaj[SUP] 5 [/SUP], Suhail Raoof[SUP] 6 [/SUP], Atul C Mehta[SUP] 7 [/SUP]
Affiliations
Background: Pneumothorax is a rare but deadly complication in patients who require mechanical ventilation. As with any condition associated with acute respiratory distress syndrome (ARDS), coronavirus disease 2019 (COVID-19) is known to be associated with pneumothorax. However, in the literature, comparative data on the risk factors for pneumothorax in COVID-19 and other diseases like influenza are limited. The aim of this study is to determine the prevalence and risk factors for pneumothorax in hospitalized COVID-19 patients and compare them with influenza pneumonia patients.
Methods: This study is a retrospective analysis of the National Inpatient Sample (NIS) 2020 database cohort. Univariate and multivariate logistic regression were used to identify the prevalence and risk factors for pneumothorax in COVID-19 patients and compared with the risk of pneumothorax in influenza patients.
Results: The NIS 2020 database includes 1,608,980 hospitalizations of COVID-19 patients, of which 22,545 [95% confidence interval (CI): 21,491-23,598] (1.4%) developed pneumothorax. On multivariate analysis, factors associated with pneumothorax in COVID-19 included patient age of 41-64 years; male sex; Hispanics, Native Americans, and other races; hospitals with large-bed size; privately owned hospitals; urban teaching hospitals; hospitals in the southern United States (US); stroke; malnutrition; chronic obstructive pulmonary disease (COPD); bronchiectasis; pulmonary fibrosis; liver disease; non-invasive and invasive ventilation; and extracorporeal membrane oxygenation (ECMO). Of 184,980 influenza patients, 1,630 (95% CI: 1,448-1,811) (0.88%) developed pneumothorax. The prevalence of pneumothorax was higher (1.4%) in COVID-19 patients compared to patients with influenza pneumonia (0.88%).
Conclusions: COVID-19 patients who develop pneumothorax have a poor prognosis. Several risk factors for the development of pneumothorax were identified. Patients with these risk factors should be prioritized in applying evidence-based guidelines to prevent pneumothorax.
Keywords: Coronavirus disease 2019 (COVID-19); influenza; pneumothorax.
. 2024 Jun 30;16(6):3593-3605.
doi: 10.21037/jtd-23-1454. Epub 2024 Jun 5. Prevalence and patient risk factors for pneumothorax in COVID-19 and in influenza pneumonia: a nationwide comparative analysis
Sanya Chandna[SUP] 1 [/SUP], Kavin Raj[SUP] 2 [/SUP], Ankit Agrawal[SUP] 1 [/SUP], Saumya Nanda[SUP] 3 [/SUP], Keerthana Jyotheeswara Pillai[SUP] 4 [/SUP], Umesh Bhagat[SUP] 1 [/SUP], Suryansh Bajaj[SUP] 5 [/SUP], Suhail Raoof[SUP] 6 [/SUP], Atul C Mehta[SUP] 7 [/SUP]
Affiliations
- PMID: 38983184
- PMCID: PMC11228741
- DOI: 10.21037/jtd-23-1454
Background: Pneumothorax is a rare but deadly complication in patients who require mechanical ventilation. As with any condition associated with acute respiratory distress syndrome (ARDS), coronavirus disease 2019 (COVID-19) is known to be associated with pneumothorax. However, in the literature, comparative data on the risk factors for pneumothorax in COVID-19 and other diseases like influenza are limited. The aim of this study is to determine the prevalence and risk factors for pneumothorax in hospitalized COVID-19 patients and compare them with influenza pneumonia patients.
Methods: This study is a retrospective analysis of the National Inpatient Sample (NIS) 2020 database cohort. Univariate and multivariate logistic regression were used to identify the prevalence and risk factors for pneumothorax in COVID-19 patients and compared with the risk of pneumothorax in influenza patients.
Results: The NIS 2020 database includes 1,608,980 hospitalizations of COVID-19 patients, of which 22,545 [95% confidence interval (CI): 21,491-23,598] (1.4%) developed pneumothorax. On multivariate analysis, factors associated with pneumothorax in COVID-19 included patient age of 41-64 years; male sex; Hispanics, Native Americans, and other races; hospitals with large-bed size; privately owned hospitals; urban teaching hospitals; hospitals in the southern United States (US); stroke; malnutrition; chronic obstructive pulmonary disease (COPD); bronchiectasis; pulmonary fibrosis; liver disease; non-invasive and invasive ventilation; and extracorporeal membrane oxygenation (ECMO). Of 184,980 influenza patients, 1,630 (95% CI: 1,448-1,811) (0.88%) developed pneumothorax. The prevalence of pneumothorax was higher (1.4%) in COVID-19 patients compared to patients with influenza pneumonia (0.88%).
Conclusions: COVID-19 patients who develop pneumothorax have a poor prognosis. Several risk factors for the development of pneumothorax were identified. Patients with these risk factors should be prioritized in applying evidence-based guidelines to prevent pneumothorax.
Keywords: Coronavirus disease 2019 (COVID-19); influenza; pneumothorax.