tetano
Editor, Senior Moderator
Respir Investig
. 2023 Dec 18;62(1):137-141.
doi: 10.1016/j.resinv.2023.12.001. Online ahead of print. Clinical features of pneumothorax associated with COVID-19: A retrospective analysis of two centres
Kohei Fujita[SUP] 1 [/SUP], Toshiyuki Iwata[SUP] 2 [/SUP], Osamu Kanai[SUP] 3 [/SUP], Hiroaki Hata[SUP] 4 [/SUP], Hiroyuki Tanaka[SUP] 5 [/SUP], Takuma Imakita[SUP] 6 [/SUP], Issei Oi[SUP] 6 [/SUP], Takao Odagaki[SUP] 7 [/SUP], Akihiro Aoyama[SUP] 8 [/SUP], Satoru Sawai[SUP] 9 [/SUP], Tadashi Mio[SUP] 6 [/SUP]
Affiliations
Background: Pneumothorax is a known sequela of coronavirus disease 2019 (COVID-19). However, the clinical features of pneumothorax associated with COVID-19 have not been fully elucidated.
Methods: Patients who developed pneumothorax within 6 months of being diagnosed with COVID-19 were retrospectively analysed at two institutions. We investigated the background factors, COVID-19 severity and treatment, timing of pneumothorax onset, treatment modalities, treatment duration, and prognosis of these patients.
Results: A total of 21 patients were diagnosed with pneumothorax within 6 months of COVID-19 diagnosis. The combined incidence rate of pneumothorax at two institutions was 0.89 %. The mean age of these patients was 72.5 years, and they were predominantly male (90.5 %), with a history of smoking (76.1 %). The most frequent comorbidity was hypertension, followed by type 2 diabetes mellitus, COPD, and malignancy. Approximately 76 % of the patients had moderate or severe disease requiring oxygenation. Moreover, 90.5 % of these patients were taking antiviral drugs; 52.4 %, immunosuppressant agents (baricitinib/tocilizumab); and 66.7 % were on dexamethasone. The median time to the onset of pneumothorax was 15.0 days, and 86 % of cases occurred within 1 month of COVID-19 diagnosis. Bilateral pneumothorax and pneumomediastinum were noted in one patient each. Chest drainage was performed in 71.4 % of the patients. The mean treatment duration for pneumothorax was 14.1 days, and the 30-day mortality rate was 28.6 %.
Conclusion: Pneumothorax associated with COVID-19 was more common in patients with moderate or severe disease requiring oxygenation, and occurred within 1 month of COVID-19 diagnosis. Pneumothorax associated with COVID-19 is a serious complication with a high mortality rate and clinicians should pay attention to it.
Keywords: COVID-19; Chest drainage; Long-COVID; Pneumothorax.
. 2023 Dec 18;62(1):137-141.
doi: 10.1016/j.resinv.2023.12.001. Online ahead of print. Clinical features of pneumothorax associated with COVID-19: A retrospective analysis of two centres
Kohei Fujita[SUP] 1 [/SUP], Toshiyuki Iwata[SUP] 2 [/SUP], Osamu Kanai[SUP] 3 [/SUP], Hiroaki Hata[SUP] 4 [/SUP], Hiroyuki Tanaka[SUP] 5 [/SUP], Takuma Imakita[SUP] 6 [/SUP], Issei Oi[SUP] 6 [/SUP], Takao Odagaki[SUP] 7 [/SUP], Akihiro Aoyama[SUP] 8 [/SUP], Satoru Sawai[SUP] 9 [/SUP], Tadashi Mio[SUP] 6 [/SUP]
Affiliations
- PMID: 38113577
- DOI: 10.1016/j.resinv.2023.12.001
Background: Pneumothorax is a known sequela of coronavirus disease 2019 (COVID-19). However, the clinical features of pneumothorax associated with COVID-19 have not been fully elucidated.
Methods: Patients who developed pneumothorax within 6 months of being diagnosed with COVID-19 were retrospectively analysed at two institutions. We investigated the background factors, COVID-19 severity and treatment, timing of pneumothorax onset, treatment modalities, treatment duration, and prognosis of these patients.
Results: A total of 21 patients were diagnosed with pneumothorax within 6 months of COVID-19 diagnosis. The combined incidence rate of pneumothorax at two institutions was 0.89 %. The mean age of these patients was 72.5 years, and they were predominantly male (90.5 %), with a history of smoking (76.1 %). The most frequent comorbidity was hypertension, followed by type 2 diabetes mellitus, COPD, and malignancy. Approximately 76 % of the patients had moderate or severe disease requiring oxygenation. Moreover, 90.5 % of these patients were taking antiviral drugs; 52.4 %, immunosuppressant agents (baricitinib/tocilizumab); and 66.7 % were on dexamethasone. The median time to the onset of pneumothorax was 15.0 days, and 86 % of cases occurred within 1 month of COVID-19 diagnosis. Bilateral pneumothorax and pneumomediastinum were noted in one patient each. Chest drainage was performed in 71.4 % of the patients. The mean treatment duration for pneumothorax was 14.1 days, and the 30-day mortality rate was 28.6 %.
Conclusion: Pneumothorax associated with COVID-19 was more common in patients with moderate or severe disease requiring oxygenation, and occurred within 1 month of COVID-19 diagnosis. Pneumothorax associated with COVID-19 is a serious complication with a high mortality rate and clinicians should pay attention to it.
Keywords: COVID-19; Chest drainage; Long-COVID; Pneumothorax.