Elsevier

Heart & Lung

Volume 50, Issue 1, January–February 2021, Pages 37-43
Heart & Lung

High incidence and mortality of pneumothorax in critically Ill patients with COVID-19

https://doi.org/10.1016/j.hrtlng.2020.10.002Get rights and content

Highlights

  • Pneumothorax may be a frequent and fatal complication in critically ill patients with COVID-19.

  • Pneumothorax was likely to occur 2 weeks after the beginning of dyspnea in senile male patients.

  • Mechanical ventilation, recruitment maneuver, forced inhalation, severely coughing, and changes of lung structure and function, contribute to the occurrence of pneumothorax. Lung recruitment maneuver should be cautiously considered.

Abstract

Background

The clinical characteristics of the patients with COVID-19 complicated by pneumothorax have not been clarified.

Objectives

To determine the epidemiology and risks of pneumothorax in the critically ill patients with COVID-19.

Methods

Retrospectively collecting and analysing medical records, laboratory findings, chest X-ray and CT images of 5 patients complicated by pneumothorax.

Results

The incidence of pneumothorax was 10% (5/49) in patients with ARDS, 24% (5/21) in patients receiving mechanical ventilation, and 56% (5/9) in patients requiring invasive mechanical ventilation, with 80% (4/5) patients died. All the 5 patients were male and aged ranging from 54 to 79 years old. Pneumothorax was most likely to occur 2 weeks after the beginning of dyspnea and associated with reduction of neuromuscular blockers, recruitment maneuver, severe cough, changes of lung structure and function.

Conclusions

Pneumothorax is a frequent and fatal complication of critically ill patients with COVID-19.

Keywords

COVID-19
Pneumothorax
Epidemiology
Mortality
Mechanism
Prevention
Coronavirus disease 2019(COVID-19)

Data for reference

  • The data could be available from the corresponding author upon reasonable request after the paper published.

Cited by (0)

1

These authors contributed equally to this study.

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