Surgical tactics for the treatment of subpleural and intra-pulmonary hematomas as a result of pneumonia caused by COVID-19

Abstract

BACKGROUND. In December 2019, cases of pneumonia of unknown etiology were detected in Wuhan (China), and later a new type of coronavirus was identified – SARS-CoV-2. In March 2020, spread of the SARS-CoV-2 was officially recognized as a pandemic.
 OBJECTIVE. To demonstrate to the doctors of the thoracic surgery and pulmonology departments our experience in the tactics of treating subpleural and intrapulmonary hematomas, which is a consequence of a coronavirus infection, and determining the need for surgical intervention.
 MATERIALS AND METHODS. From the beginning of the COVID-19 pandemic on the basis of the clinical department of the surgical treatment of tuberculosis and non-specific diseases complicated by purulent-septic infections of the SI “National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine” treated 11 patients with spontaneous hematomas of post-COVID genesis, of which subpleural hematomas accounted for 9 cases (81.8 %), and intrapulmonary – 2 (18.2 %). The distribution by gender was as follows: 7 (63.6 %) women were treated, and 4 (36.4 %) men. The age of the patients ranged from 28 to 70 years, the average age was 45 years. This group of patients had the following associated pathologies: chronic obstructive pulmonary disease – 3 (27.3 %), hypertension – 3 (27.3 %), diabetes – 2 (18.2 %), chronic renal failure – 1 (9.0 %), ischemic heart disease – 2 (18.2 %).
 CONCLUSIONS. Lack of timely diagnosis and surgical treatment of subpleural and intrapulmonary hematomas often leads to the addition of secondary infection, which complicates the treatment process.