Pneumothorax emerging as a new complication of COVID-19, reports study

A total of 71 patients were reviewed, of whom 60 patients had pneumothoraces (six also with pneumomediastinum), whilst 11 patients had pneumomediastinum alone. Two patients had two distinct episodes of pneumothorax, occurring bilaterally in a sequential fashion, bringing the total number of pneumothoraces included to 62. Clinical scenarios included patients who had presented to the hospital with pneumothorax, patients who had developed pneumothorax or pneumomediastinum during their inpatient admission with COVID-19 and patients who developed their complications whilst intubated and ventilated, either with or without concurrent extracorporeal membrane oxygenation.

Results revealed the following facts.

• Of the 60 patients with pneumothorax, 58 were laboratory confirmed COVID-19 infection with two diagnosed based on clinical history and radiology. Sixty-one pneumothoraces were confirmed by chest radiograph, whilst one case was diagnosed by suspicious radiology before deterioration.
• Survival at 28 days was not significantly different following pneumothorax (63.1%±6.5%) or isolated pneumomediastinum (53.0%±18.7%; p=0.854).
• The incidence of pneumothorax was higher in males. The 28-day survival was not different between the sexes (males 62.5%±7.7% versus females 68.4%±10.7%; p=0.619).
• Patients above the age of 70 had a significantly lower 28-day survival than younger individuals (≥70 years 41.7%±13.5% survival versus <70 years 70.9%±6.8% survival; p=0.018 log-rank).

"We have described the largest series of pneumothoraces in the context of COVID-19 that includes non-ventilated patients. Although heterogeneous, these cases provide important insights into the association between pneumothorax and COVID-19." wrote the team.

Primary source: European Respiratory Journal

For the full article follow the link: 10.1183/13993003.02697-2020