Iatrogenic Barotrauma in COVID-19-Positive Patients: Is It Related to the Pneumonia Severity? Prevalence and Trends of This Complication Over Time

Abstract

COVID-19 has attracted worldwide attention ever since the first case was identified in Wuhan (China) in December 2019 and was classified, at a later time, as a public health emergency of international concern in January 2020 and as a pandemic in March 2020. The interstitial pneumonia caused by COVID-19 often requires mechanical ventilation, which can lead to pulmonary barotrauma. We assessed the relationship between pneumonia severity and the development of barotrauma in COVID-19-positive patients mechanically ventilated in an intensive care unit; we therefore analyzed the prevalence of iatrogenic barotrauma and its trends over time during the pandemic in COVID-19-positive patients undergoing mechanical ventilation compared to COVID-19-negative patients, making a distinction between different types of ventilation (invasive mechanical ventilation vs. noninvasive mechanical ventilation). We compared CT findings of pneumomediastinum and pneumothorax in 104 COVID-19-positive patients hospitalized in an intensive care unit and 101 COVID-19-negative patients undergoing mechanical ventilation in the period between October 2020 and December 2021. The severity of pneumonia was not directly correlated with the development of barotrauma. Furthermore, a higher prevalence of complications due to barotrauma was observed in the group of mechanically ventilated COVID-19-postive patients vs. COVID-19-negative patients. A higher rate of barotrauma was observed in subgroups of COVID-19-positive patients undergoing mechanical ventilation compared to those treated with invasive mechanical ventilation. The prevalence of barotrauma in COVID 19-positive patients showed a decreasing trend over the period under review. CT remains an essential tool in the early detection, diagnosis, and monitoring of the clinical course of SARS-CoV2 pneumonia; in evaluating the disease severity; and in the assessment of iatrogenic complications such as barotrauma pathology.

COVID-19 on Oral Health: A New Bilateral Connection for the Pandemic

“…Therefore, the periodontal pocket may serve as an advantageous reservoir for latent and active SARS-CoV-2 isoforms [5,47]. As a result, the mouth cavity is a crucial location and a possible pathway for the cellular and acellular particles of SARS-CoV-2 to become infected through saliva [2,27].…”

“…SARS-CoV-2 can start its viral envelope entrance by Several oral lesions were found in COVID-19 patients. Amongst them, the m commonly reported are: geographic tongue, herpes simplex, aphthous-like ul candidiasis, hemorrhagic and necrotic ulcerations, erythematous surfaces, red macules, white hairy tongue, petechiae, and pustular enanthema [1,2]. This review ar will consider and analyze the existing evidence on the molecular processes of infection by SARS-CoV-2.…”