Hemopneumothorax and pneumothorax as complication of COVID­19 (cases from practice)

Abstract

There are two types of coronary infection: SARS-CоV and MERS-CоV. The following crown infection, COVID-19, has been reported in China. The disease has spread rapidly around the world, changing the rhythm of life in most countries. The consequences of this infection have not been fully appreciated by humanity as a whole. Because the virus mainly affects the vascular endothelium, complications can affect all organs and systems. The most common sign of the disease is shortness of breath and weakness. Shortness of breath is caused by hypoxemia and hypoxia. An objective manifestation of hypoxia is the level of oxygen saturation of the blood. When its value is less than 92—90 %, there is a need for oxygen therapy. The most common complications of COVID-19 are pneumonia (15.7—100 %), acute respiratory distress syndrome (3—90 %), and heart and liver damage (4—53 %). Given this, the attention of doctors is focused on the possibility of these complications. Traditionally, visual inspection (CT) is performed on days 12—18 of treatment. During this period, a number of complications can occur. Among the latter, which are manifested by shortness of breath, maybe pleural effusion syndrome, pneumothorax, hemothorax, pyopneumothorax. It is challenging to diagnose complications in the conditions of oxygen therapy and artificial ventilation, which determines the problem’s urgency.
 Objective — is the need to share the experience of untimely diagnosis of complications such as pneumothorax and hemopneumothorax.
 Materials and methods. There were three patients with COVID-19, complicated in two patients with pneumothorax, in one - hemopneumothorax under our supervision. Examinations were performed according to standard clinical methods using radio methods and pulse oximetry.
 Results and discussion. Consultations of the department staff on external respiratory disorders and hypoxia with the use of physical methods allowed to state complications. All patients underwent drainage of the pleural cavity on the background of mechanical ventilation. Hemopneumothoraxwas confirmed in one of these patients. This patient survived. The other 2 died.
 Conclusions. At active supervision of patients with COVID-19 with hypoxia signs, physical methods of inspection (palpation and percussion) should be applied regularly, not less than three times a day, and according to indications. Ultrasound or examination radiography is enough to confirm the complication.