Commentary: Pneumatocele and cysts in a patient with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection—yet another new complication associated with coronavirus disease 2019 (COVID-19)

Post-COVID-19 pneumonia pneumatoceles: a case report

“…Infected pneumatocele may also require consultation with thoracic surgeons. However, it has been debated to consider inserting percutaneous drain for management of pneumatocele in COVID-19 pneumonia cases with a high likelihood of clinical deterioration [ 15 ]. Pneumatocele rupture resulting in a pneumothorax in severe COVID-19 patients, especially those on positive pressure ventilation, can cause life-threatening clinical deterioration.…”

Large pneumatocele as a rare complication in SARS-CoV-2 infection of the lung

“…While observation works in a most cases, it may not be appropriate in COVID-19 with respiratory deterioration. Ramzy et al recommended that especially in patients with a large pneumatocele, percutaneous drainage treatment is an appropriate choice [19]. In such complicated cases, and when occupying >50% of the hemithorax, a percutaneous decompression has been successfully tried in numerous cases [12,[19][20][21][22].…”

“…Ramzy et al recommended that especially in patients with a large pneumatocele, percutaneous drainage treatment is an appropriate choice [19]. In such complicated cases, and when occupying >50% of the hemithorax, a percutaneous decompression has been successfully tried in numerous cases [12,[19][20][21][22]. However, as our case in a patient with bilateral COVID-19-pneumonia subtly demonstrated, and as also observed by others, the drainage of the pulmonary cyst may instigate a pneumothorax, which we could treat efficiently with a chest tube placement without causing further troubles like infections including empyema and abscess formation, fistulae, pneumomediastinum and hemothorax [19].…”

“…In such complicated cases, and when occupying >50% of the hemithorax, a percutaneous decompression has been successfully tried in numerous cases [12,[19][20][21][22]. However, as our case in a patient with bilateral COVID-19-pneumonia subtly demonstrated, and as also observed by others, the drainage of the pulmonary cyst may instigate a pneumothorax, which we could treat efficiently with a chest tube placement without causing further troubles like infections including empyema and abscess formation, fistulae, pneumomediastinum and hemothorax [19]. If the pneumatocele of our case would have caused those or similar severe complications, surgery would have been the only remaining treatment option [18].…”

Commentary: Covid-19 Pneumonitis and Cystic Lung Disease, Pneumothorax and Pneumomediastinum

“…For example, pig-tail catheter drainage of pneumatoceles 7 . However, as yet there remains insufficient evidence base to suggest whether their widespread use would be superior to conservative management alone 8 . We need a unified evidence-based approach, and need to encourage discussion surrounding management of cysts in covid-19.…”