Pneumothorax in Coronavirus Disease-19 Patients: A Retrospective Case Series

Abstract

Objective: Pneumothorax may develop secondary to alveolar damage and barotrauma in Covid- 19 patients. In this study, in the light of the literature. we aimed to present Covid-19 patients who developed pneumothorax among whom we followed up in the intensive care unit. Methods: Eleven patients among 2680 patients tested positive for Covid-19 in the PCR test and developed pneumothorax in the radiologic examination were included in the study. The data were obtsined from patient follow-up forms and electronic medical records. Demographic data, blood and biochemical parameters, blood culture results, time and location of development of pneumothorax, modality, and duration of pneumothorax treatment, and mortality data were recorded. Results: The frequency of development of pneumothorax was found to be 0.41%. The most common complaint was dyspnea. Comorbidiites were observed in 9 (81.8%) patients and the most common comorbidity was hypertension. It was determined that 3 (27.2%) patients did not smoke, 4 patients(36.3%) were active smokers, and 4 (36.3%) patients were ex-smokers. The mean age was 69±14.8 years, the APACHE II score were 18.8±8.7, the female/male ratio was 3/8, and the the time to pneumothorax development was 10.7±11.8 days. Pneumothorax developed in 3 (27.27%) patients on noninvasive mechanical ventilation and 8 (72.7%) patients on invasive mechanical ventilation. The mean length of stay in the intensive care unit was 21.6±26.5 days. It was found that 10 (90.9%) patients died and the mean time to mortality was 19.5±27.0 days. Conclusion: In Covid-19 infection, lung protective ventilation strategies should be adopted and it should be known that the development of pneumothorax is a late complication that increases mortality and morbidity. (English) [ABSTRACT FROM AUTHOR] Amac: Covid-19 hastalarinda alveolar hasar ve barotravmaya sekonder pnomotoraks gelisebilir. Bu calismada, yogun bakim unitesinde takip ettigimiz Covid-19 hastalarindan pnomotoraks gelisenlerini literatur esliginde sunmayi amacladik. Yontem: Calismaya PCR testi pozitif oldugu saptanan 2.680 hastadan radyolojik olarak pnomotoraks gelistigi belirlenen 11 hasta dahil edildi. Veriler hasta takip formlari ve elektronik tibbi kayitlardan alindi. Demografik veriler, tam kan ve biyokimyasalparametreleri, kan kultur sonuclari, pnomotoraks gelisim zamani ve lokasyonu, pnomotoraks tedavi sekli, mortalite ve suresi kaydedildi. Bulgular: Pnomotoraks gelisme sikligi %0,41 bulundu. En sik basvuru yakinmasinin dispne oldugu saptandi. Dokuz (%81.8)hastada comorbidite oldugu ve en sik gozlenen comorbiditenin hipertansiyon oldugu goruldu. Uc (%27,2) hastanin sigara kullanmadigi, 4(%36,3) hastanin aktif sigara icicisi oldugu ve 4 (%36.3) hastanin sigarayi biraktigi saptandi. Hastalarin yas ortalamalari 69±14,8 yil, APACHE II skor ortalamalari 18,8±8,7, kadin/erkek orani 3/8 ve pnomotoraks gelisene 10,7±11,8 gun bulundu. Uc hastada (%27.27) noninvaziv mekanik ventilasyonda ve 8 hastada (%72,7) invaziv mekanik ventilasyondayken pnomotoraks gelistigi saptandi. Yogun bakim unitesinde ortalama kalma suresi 21,6±26,5 gundu. On (%90,9) hastanin eks oldugu ve eks olana kadar ortalama 19,5±27,0 gun gectigi saptandi. Sonuc: Covid-19 infeksiyonu sirasinda hipoksemi tedavi edilirken, akciger koruyucu ventilasyon stratejileri benimsenmeli ve pnomotoraks gelisiminin mortalite ve morbiditeyi arttiran gec donem komplikasyon oldugu bilinmelidir. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)