Pleural effusion as an indicator for the poor prognosis of COVID‐19 patients

Abstract

Background Coronavirus Disease 19 (COVID‐19) is a global health concern that has become a pandemic over the past few months. This study aims at understanding the clinical manifestations of COVID‐19 patients with pleural effusion. Methods COVID‐19 patients were retrospectively enrolled from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Pharyngeal swabs from patients were tested using real‐time polymerase chain reaction. Patients with COVID‐19 were divided into two groups based on their computed tomography (CT) scans for the presence of pleural effusion at admission. We compared the clinical features, laboratory findings, scans and clinical outcomes between the two groups. Results Pleural effusion was observed in 9.19% of the patients. Patients with pleural effusion were more likely to be severe or critical cases. Moreover, patients with pleural effusion were associated with increased mortality. Of the 799 discharged patients, patients with pleural effusion had longer hospital stays and duration of viral shedding since the onset of symptoms as compared with that for patients without pleural effusion. After discharge, 217 patients visited for a follow‐up CT re‐examination at the Union Hospital. The CT scans showed that patients with pleural effusion required a longer time to resolve the lung inflammation after the onset of COVID‐19 as compared with the time required by patients without pleural effusion. Conclusion This population of patients requires special attention and pleural effusion may be an indicator of poor prognosis in COVID‐19 patients.

Pleural effusion in a COVID-19 patient

“…We present a case of pleural effusion in a COVID-19 female patient, in whom pleural effusion developed at a later stage of the progression of disease (Figure 2), which coincides with what Salehi et al reported in their study [6], while Zhang et al reported on a case of COVID-19 with pleural effusion as an initial symptom [12]. Song et al found that pleural effusion resolved after two days [10].…”

“…Prikazujemo slučaj pleuralnog izliva kod bolesnice obolele od KOVID-19 oboljenja kod koje se pleuralni izliv javio kasnije u toku progresije bolesti (Slika 2), što je u skladu sa izveštajem Salehija i saradnika [6], dok su Žang i saradnici prikazali slučaj KOVID-19 oboljenja sa pleuralnim izlivom kao inicijalnim simptomom [12]. Song i saradnici izveštavaju da se pleuralni izliv apsorbuje već nakon dva dana [10].…”

Can Lung Ultrasound Be the Ideal Monitoring Tool to Predict the Clinical Outcome of Mechanically Ventilated COVID-19 Patients? An Observational Study

“…Furthermore, although beyond the scope of this study, we need to recode the role that LUS has outside the diagnosis or monitoring of COVID-19 patients. LUS is also useful as a guiding tool during invasive procedures: LUS is a particularly suitable tool for bedside procedures, such as the drainage of pleural effusions that complicate the course of COVID-19 patients in a not-so-small percentage [ 2 , 22 ]. This result is particularly relevant if we consider the logistical difficulties of moving a highly infectious patient to the Radiology Department [ 23 , 24 ].…”

Time to hospitalisation, CT pulmonary involvement and in‐hospital death in COVID‐19 patients in an Emergency Medicine Unit

“…The typical pattern at the chest CT is represented by bilateral interstitial involvement sometimes with consolidative abnormalities. Additional features found in some patients are septal thickening superposes on the ground glass opacification (crazy pattern), bronchiectasis, pleural effusion, 19 pericardial effusion and lymphadenopathy. The lung involvement is almost always bilateral, with the prevalence of peripheral distribution and focused at the lower lobes of the lungs, at least in the less severe conditions.…”