Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects mainly the lungs causing pneumonia and complications like acute respiratory distress syndrome. Pneumothorax is a rare manifestation of the disease. This report is a description of a series of patients with COVID-19 and spontaneous pneumothorax, some of them with associated pulmonary cysts. Cases were collected retrospectively. We included clinical data from medical records and described radiologic findings. Patients that developed pneumothorax during mechanical ventilation were excluded. Ten cases were included in this report, nine of them were male. The median age of our series was 62 years (IQR = 57-68). The median days since the onset of symptoms until the development of pneumothorax was 27 (IQR = 17-31), most cases developed after the second week of the diagnosis of pneumonia. Two cases required invasive mechanical ventilation, but pneumothorax occurred after ventilator weaning. Three cases showed subpleural pulmonary cysts. Cysts and pneumothorax are rare manifestations of SARS-CoV-2 pneumonia with mechanisms not completely understood. This report highlights the role of CT scan in diagnosis of COVID-19 complications.
Highlights
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects mainly the lungs causing pneumonia and complications like acute respiratory distress syndrome
This report is a description of a series of patients with COVID-19 and spontaneous pneumothorax, some of them with associated pulmonary cysts
Spontaneous pneumothorax and pulmonary cystic spaces have been reported as a rare complication of COVID-19
Summary
Coronavirus disease 2019 (COVID-19) has become a health emergency worldwide causing pneumonia as its main manifestation. Spontaneous pneumothorax and pulmonary cystic spaces have been reported as a rare complication of COVID-19. The aim of this report is to describe cases of patients from a single-center with COVID-19 pneumonia and spontaneous pneumothorax, not related to mechanical ventilation, in some cases associated with pulmonary cysts. Cases report We collected retrospectively ten laboratoryconfirmed COVID-19 patients that developed spontaneous pneumothorax. Patients that developed pneumothorax during mechanical ventilation were excluded. The median days since the onset of symptoms until the development of pneumothorax was 27 (IQR = 17-31), only two patients developed this complication in the first two weeks. Patients underwent chest CT scanning that showed multilobe subpleural consolidations or ground-glass opacities once COVID-19 was diagnosed. Three cases with CT scan follow-up showed evidence of subpleural thinwalled cystic spaces development associated with pneumothorax (Figure 1). This report was approved by the Medical Ethic Committee of Rosario University
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