Persistent pneumothorax with bronchopleural fistula in COVID lung – An emerging challenge

Abstract

Bronchopleural fistula (BPF) is an uncommon entity in patients with coronavirus disease 2019 (COVID-19). It may arise due to various causes ranging from the disease itself to complications of treatment. If left untreated, it may increase the morbidity, hospital stay, and adversely affect the outcome. We hereby present a series of cases with a persistent pneumothorax and associated BPF due to varying etiologies. While three of our cases developed a pneumothorax while on non-invasive ventilation, other three were on oxygen therapy. One patient developed a spontaneous pyopneumothorax and septicemia and succumbed to the complications. Another patient on non-invasive ventilation died due to complications of pregnancy. The management of each case varied depending on their clinical presentation.

Surgical paradigm for lung injury secondary to COVID-19

“…In post-COVID patients, lung injury can lead to these complications. Surgery is indicated when there is a failure of conservative management and endobronchial valve exclusion is not possible ( 13 ).…”