A Current and Common Cause of Secondary Spontaneous Pneumothorax: Covid- 19 Pneumonia

Abstract

This study evaluated cases of spontaneous pneumothorax developing secondary to SARS-CoV-2 pneumonia. Sixteen cases presenting to our hospital due to spontaneous pneumothorax developing secondary to SARS-CoV-2 pneumonia between March 2020 and February 2020 were evaluated retrospectively. Ten patients (62.5%) were men, and six (37.5%) were women, with a mean age of 68 ± 20.3 years (range 18 - 90 years). Pneumothorax was in the right hemithorax in 11 cases (68.75%), in the left hemithorax in two (12.5%), and bilateral in three (17.75%). Pneumothorax developed during active SARS-CoV-2 pneumonia in all 16 cases (100%). No pneumothorax was detected following the healing of SARS-CoV-2 infection. Pneumothorax was observed while patients were not intubated in 15 cases (93.75%), but pneumothorax developed during mechanical ventilation in one case (6.25%). Tube thoracostomy was performed on all patients in treatment. Air leakage from the tube was observed in 14 cases (87.5%). The mean duration of tube thoracostomy was 18.3 ± 20.1 days (range 1 - 81 days). Pneumothorax resolved after treatment in seven cases (43.75%), while mortality occurred in nine (56.25%). Pneumothorax recurred after treatment in one case (6.25%). Pneumothorax is widely seen in the active period or after healing in cases infected with COVID-19. Aggressive treatment is generally required for this clinical manifestation with high mortality.