Bilateral Hemopneumothorax in COVID-19

Salah, Omer; Faisal, Mohannad; Alshahwani, Israa; Elhiday, Abdelhaleem

doi:10.7759/cureus.10314

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…The exact pathogenetic mechanism leading to spontaneous pneumothorax is not completely elucidated. However, the most probable mechanism is alveolar damage because of the inflammation and ischemic process (12)(13)(14)16). Common histopathological findings in COVID19 patients are capillary congestion and reactive pneumocyte changes indicating diffuse alveolar damage (12,13).…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax in otherwise healthy non-intubated patients suffering from COVID-19 pneumonia: a systematic review

Agrafiotis¹,

Rummens²,

Lardinois³

2021

J Thorac Dis

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Background: Cases of spontaneous pneumothorax have been described in patients suffering from coronavirus disease 2019 (COVID-19) pneumonia. The aim of this study is to systematically review all the cases of spontaneous pneumothorax that occurred in healthy patients with no underlying lung disease and who did not receive invasive mechanical ventilation.Methods: A PubMed research was conducted. The following data were collected: age, sex, side of the pneumothorax, smoking habit, time form onset of symptoms to the diagnosis of pneumothorax, the development of new bullous lesions on computed tomography and the type of treatment. In order to analyze the most homogeneous population possible, intubated patients were deliberately excluded. In total, 44 cases of spontaneous pneumothorax in otherwise healthy patients were taken into account. Since the available data were extracted from small observational studies, no particular bias risk assessment was performed.Descriptive statistics were used to synthesize results.Results: There were 37 male (84.1%) and 6 female (13.6%) patients. The majority of patients (66%) were treated only by chest tube thoracostomy, which most of the times resulted in a complete resolution of the pneumothorax. Simple surveillance was applied in 10 cases. Three patients underwent minimally invasive surgery. In 14 cases (31.8%) air-filled lesions were detected on imaging. Eleven patients received corticosteroids during their hospital stay. In the majority of cases (86.3%) the pneumothorax was resolved.Discussion: Even if the level of evidence, derived from case reports and small case series is low, the existence of a true secondary spontaneous pneumothorax due to SARS-CoV-2 should be recognized.Imaging techniques should be repeated throughout the clinical course of the patients in order to detect newly developed pulmonary complications. Surgical treatment is feasible and patients whose general condition permits, should be offered surgery according to the existing guidelines regarding spontaneous pneumothorax. National registries and databases are necessary in order to better understand the pathogenesis and complications of this novel entity.

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Section: Discussionmentioning

confidence: 99%

Pneumothorax in otherwise healthy non-intubated patients suffering from COVID-19 pneumonia: a systematic review

Agrafiotis¹,

Rummens²,

Lardinois³

2021

J Thorac Dis

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“…On the other hand, TB is the leading cause of death from a single infectious agent. 8 Like its previous ancestors SARS-COV-1 and MERS related Coronavirus, TB-COVID-19 coinfection have been reported though data are limited. 9 As both diseases have overlapping clinical features and the same transmission mode, such co-infections are not uncommon.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 with pulmonary tuberculosis with unilateral hydropneumothorax: case report from a primary care center in Bangladesh

Podder¹,

Chowdhury²

2021

JDMDC

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Coronavirus disease 2019 , the latest global pandemic has already presented with a diverse range of complications. Hydropneumothorax has been a rarer one and has been observed without preexisting lung disease and mechanical ventilation. On the other hand, Pulmonary Tuberculosis is a well-established cause of hydropneumothorax. Historically, corona viral illness had been observed to be complicated with pneumothorax and coinfection with tuberculosis .This case report enumerates concurrent tuberculosis and COVID-19 and their common grave consequence hydropneumothorax.

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“…Salah et al suggested that complication induced cystic changes within the lung might be a reason. 20 Regarding hydrothorax, Light's criteria showed that all the effusions were exudate. These inflammatory exudates might be related to interstitial lung disease caused by COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of pleural drainage on pneumothorax and hydrothorax in critically ill patients with COVID-19: A case series with literature review

Liu

2021

Heart & Lung

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Background: For patients with COVID-19, pneumothorax and hydrothorax are suggested to be negative prognostic indicators. However, the management of these two conditions has rarely been discussed. We aimed to describe the clinical outcomes of pleural drainage in critically ill patients with COVID-19. Methods: A total of 17 pleural drainages were performed in 11 critically ill patients with pneumothorax or hydrothorax. Either chest tubes or central venous catheters (CVCs) were used. The clinical outcomes, including respiratory and circulation indicators at 24 h and 1 h before the procedure and 24 h and 48 h after the procedure, were retrospectively recorded. Results: (1) Following pleural drainage, there was a 19.1% improvement in the PaO 2 /FiO 2 ratio from 147.4 mmHg (-1 h) to 175.5 mmHg (24 h), while the mean positive end expiratory pressure (PEEP) decreased from 10.7 cmH 2 O (-1 h) to 8.9 cmH 2 O (24 h) and 8.1 cmH 2 O (48 h). The A-a gradients decreased from 313.3 mmHg (-1 h) to 261.3 mmHg (24 h). (2) The dosage of norepinephrine increased from 0.15 mg/kg/min (-1 h) to 0.40 mg/kg/min (24 h). (3) No haemorrhagic or infectious complications were observed. (4) A total of 41.6% of CVCs were partially or fully obstructed, while no chest tubes were obstructed. Conclusion: For critically ill patients with COVID-19, pleural drainage leads to a significant improvement in oxygenation and gas exchange, but the deterioration of circulation is not reversed. It is safe to perform pleural drainage even though anticoagulation therapy and glucocorticoids are widely used. Chest tubes rather than CVCs are recommended.

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Bilateral Hemopneumothorax in COVID-19

Cited by 7 publications

References 9 publications

Pneumothorax in otherwise healthy non-intubated patients suffering from COVID-19 pneumonia: a systematic review

Pneumothorax in otherwise healthy non-intubated patients suffering from COVID-19 pneumonia: a systematic review

COVID-19 with pulmonary tuberculosis with unilateral hydropneumothorax: case report from a primary care center in Bangladesh

Clinical outcomes of pleural drainage on pneumothorax and hydrothorax in critically ill patients with COVID-19: A case series with literature review

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