COVID-19 and spontaneous pneumothorax: a survival analysis

Ershadi, Reza; Rafieian, Shahab; Salehi, Mohammadreza; Kazemizadeh, Hossein; Amini, Hesam; Sohrabi, Marjan; Samimiat, Alireza; Sharafi, Y.; Dashtkoohi, Mohadese; Vahedi, Matin

doi:10.1186/s13019-023-02331-0

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…Video-assisted thoracoscopic surgery (VATS) is often employed in applying pleurodesis since it enables the surgeon to completely visualize the pleural cavity and detect and treat pulmonary lesions before performing the pleurodesis ( 62 ). Ershadi et al describe that 80.6% of pneumothoraces are managed with chest tubes, while 13.4% are managed with conservative measures and 6% with surgical intervention ( 63 ).…”

Section: Pmd and Pnxmentioning

confidence: 99%

“…Along with the increased incidence of PNX, the mortality rate associated with PNX in COVID-19 patients with ARDS is significantly high, with studies demonstrating an increased mortality rate of 40–50% ( 63 , 91 ). A complication of PNX or PMD in patients with COVID-19 and ARDS leads to greater length of hospitalization, higher mechanical ventilatory requirements, and greater in-hospital mortality ( 92 ).…”

Section: Pmd and Pnxmentioning

confidence: 99%

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Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

Teo,

Geetha,

Mishra

et al. 2024

Mediastinum

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Background and Objective Acute respiratory distress syndrome (ARDS) is a severe, life-threatening medical condition characterized by poor oxygenation due to non-compliant lungs secondary diffuse alveolar damage. Encouragingly, the incidence of ARDS has declined steadily recently, attributed mainly to implementation of keystone guidelines and continuous research efforts. Mechanical ventilation is the cornerstone of supportive care for ARDS patients. This review aims to consolidate the current knowledge on pneumothorax (PNX) and pneumomediastinum (PMD) and to enhance the understanding of the readers. The objectives are to (I) explore the etiology and risk factors of PNX and PMD, (II) discuss the various diagnostic modalities available, (III) evaluate management options, and (IV) recent advancements. Methods A search of the literature was conducted using PubMed, MEDLINE, and Google Scholar for relevant articles pertaining to PNX and PMD in ARDS population. The clinical presentation, diagnostic and management strategies of PNX, PMD, and ARDS were summarized, and all authors reviewed the selection and decide which studies to include. Key Content and Findings The adoption of lung-protective ventilation strategies, based on the review of literature from the recent years, shows that it has played a significant role in reducing the occurrence of barotrauma, such as PNX and PMD. However, PNX and PMD remains to be a challenging complication to manage. With a specific focus on PNX and PMD, this review provides valuable insights into effectively managing and understanding these critical complications among ARDS patients. Conclusions ARDS, with its evolving definition, continues to pose a life-threatening threat. Despite the widespread adoption of lung-protective ventilation strategies, PNX and PMD present persistent challenges in management. Further research is imperative to enhance the risk assessment of ARDS patients prone to developing PNX and PMD and to institute more effective prevention and treatment measures.

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Section: Pmd and Pnxmentioning

confidence: 99%

Section: Pmd and Pnxmentioning

confidence: 99%

Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

Teo,

Geetha,

Mishra

et al. 2024

Mediastinum

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“…The spectrum of symptoms ranges from upper respiratory issues like cough and congestion to more severe conditions such as ARDS [3]. Spontaneous pneumothorax is a known respiratory complication associated with COVID-19, with an incidence of about 1% in hospitalized patients and a reported mortality rate ranging from 33% to 52% [4][5][6][7]. However, the occurrence of bilateral pneumothorax is exceedingly rare.…”

Section: Introductionmentioning

confidence: 99%

A Case of Bilateral Pneumothorax With COVID-19 Infection

Bergeron,

Emeshiobi,

Nwankwo

et al. 2023

Cureus

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Bilateral spontaneous pneumothorax is a serious complication of coronavirus disease 2019 . The incidence of any spontaneous pneumothorax in patients with the aforementioned viral infection when hospitalized is about 1%. Treatment can involve management such as oxygen support, tube thoracostomy, pleurodesis, or even invasive surgery. The associated mortality with this complication is about 33% to 52%. We present a case of bilateral pneumothorax in a patient diagnosed with COVID-19 without any history of smoking or underlying lung disease. Careful vigilance and close monitoring of this serious complication are mandatory in inpatients.

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Impact of pneumothorax on mortality, morbidity, and hospital resource utilization in COVID-19 patients: a propensity matched analysis of nationwide inpatient sample database

Nasrullah,

Quazi,

Virk

et al. 2024

BMC Pulm Med

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Background Spontaneous pneumothorax (PTX) is more prevalent among COVID-19 patients than other critically ill patients, but studies on this are limited. This study compared clinical characteristics and in-hospital outcomes among COVID-19 patients with concomitant PTX to provide insight into how PTX affects health care utilization and complications, which informs clinical decisions and healthcare resource allocation. Methods The 2020 Nationwide Inpatient Sample was used analyze patient demographics and outcomes, including age, race, sex, insurance status, median income, length of hospital stay, mortality rate, hospitalization costs, comorbidities, mechanical ventilation, and vasopressor support. Propensity score matching was employed for additional analysis. Results Among 1,572,815 COVID-19 patients, 1.41% had PTX. These patients incurred significantly higher hospitalization costs ($435,508 vs. $96,668, p < 0.001) and longer stays (23.6 days vs. 8.6 days, p < 0.001). In-hospital mortality was substantially elevated for PTX patients (65.8% vs. 14.4%, p < 0.001), with an adjusted odds ratio of 14.3 (95% CI 12.7–16.2). Additionally, these patients were more likely to require vasopressors (16.6% vs. 3.3%), mechanical circulatory support (3.5% vs. 0.3%), hemodialysis (16.6% vs. 5.6%), invasive mechanical ventilation (76.9% vs. 15.1%), non-invasive mechanical ventilation (19.1% vs. 5.8%), tracheostomy (13.3% vs. 1.1%), and chest tube placement (59.8% vs. 0.8%). Conclusions Our findings highlight the severe impact of PTX on COVID-19 patients, characterized by higher mortality, more complications, and increased resource utilization. Also, being Hispanic, male, or obese increased the risk of developing concomitant PTX with COVID-19.

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COVID-19 and spontaneous pneumothorax: a survival analysis

Cited by 5 publications

References 31 publications

Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

A Case of Bilateral Pneumothorax With COVID-19 Infection

Impact of pneumothorax on mortality, morbidity, and hospital resource utilization in COVID-19 patients: a propensity matched analysis of nationwide inpatient sample database

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