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Introduction: Pneumothorax is a condition that usually occurs in thin, young people, especially in smokers. It is an unusual complication of COVID-19 disease that can be associated with worse results. This disease can occur without pre-existing lung disease or without mechanical ventilation. Materials and Methods: We present a monocentric comparative retrospective study of diagnostic and treatment analysis of two groups of patients diagnosed with COVID-19 and non-COVID-19 pneumothorax. All patients included in this study underwent surgery in a thoracic surgery department. The study was conducted over a period of 18 months. It included 34 patients with COVID-19 pneumothorax and 42 patients with non-COVID-19 pneumothorax. Results: The clinical symptoms were more intense in patients with COVID-19 pneumothorax. We found that the patients with COVID-19 had significantly more respiratory comorbidities. Diagnostic procedures include chest CT exam for both groups. Laboratory findings showed that increasing values for the analyzed data were consistent with the deterioration of the general condition and the appearance of pneumothorax in the COVID-19 group. The therapeutic attitude regarding the non-COVID-19 group was to eliminate the air from the pleural cavity and surgical approach to the lesion that determined the occurrence of pneumothorax. The group of patients with COVID-19 pneumothorax received systemic treatment, and only minimal pleurotomy was performed. The surgical approach did not alter patients’ survival. Conclusions: Careful monitoring of the patient’s clinic and laboratory tests evaluating the degradation of the lung parenchyma, correlated with the imaging examination (chest CT) is mandatory and reduces COVID-19 complications. Early imaging examination starts an effective diagnosis and treatment management. In severe COVID-19 pneumothorax cases, the pneumothorax did not influence the evolution of COVID-19 disease. When we found that the general condition worsened with the rapid progression of dyspnea and the deterioration of the general condition, and we found that it represented the progression or recurrence of pneumothorax.

Background: Spontaneous pneumothorax is a type of air collection in the pleural cavity that it develops in the absence of trauma or an iatrogenic cause. It may become an emergency in thoracic surgery. The anatomical substrate of spontaneous pneumothorax is represented by blisters. But we must not minimize the emphysema bubbles that appear in the lung parenchyma, which may also be a common cause of spontaneous pneumothorax. In order to appear the spontaneous pneumothorax, it is considered necessary to have an area of minimal resistance in the visceral pleura and also a triggering element. For decades, the therapeutic options are been discussed. Objectives: literature review and updating of scientific data Method: The management of conservative treatment is known, ambulatory air aspiration, drain tube installation, video-assisted thoracoscopic surgery The use of chemical pleurodesis-betadine versus talc and mechanical-pleural abrasion, resection of blisters or ligature at their base, apical pleurectomy, are therapeutic options that are custom applied for each case. The current diagnostic and treatment guidelines have been designed about 10 years ago and with a little change. Results: We support the use as a chemical agent of betadine to prevent recurrences with a similar effect to that of talc. We concluded that the introduction of betadine into the drain tube after minimal pleurotomy for symphysis, can sometimes lead to local pain, sometimes atrocious, unbearable, even simulating the myocardial infarction pain. Therefore, before applying the chemical, we recommend the systemic analgesics and local analgesic from the amide group. Video-assisted thoracic surgery is the main surgical technique for treating pneumothorax in order to prevent recurrences. Conclusions-We considered necessary a mini-revision of the literature in order to update the scientific data and the effective treatment methods with the mention of some own amendments regarding the therapeutic options.

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