Case Report: COVID-19–Related Pneumothorax—Case Series Highlighting a Significant Complication

Al-Shokri, Shaikha D.; Ahmed, Afif; Saleh, Ahmed Osman; Aboukamar, Mohamed; Ahmed, Khalid; Mohamed, Mouhand

doi:10.4269/ajtmh.20-0713

Cited by 25 publications

(29 citation statements)

References 14 publications

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“…However, the associated severity and prognosis of spontaneous pneumothorax concomitantly in COVID-19 infection has yet to be established [ 9 ]. Interestingly, in our case study and others, pneumothorax occurred days to weeks after onset of symptoms [ 1 , 2 , 3 , 4 , 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Even though our patient did not present with evidence of cysts or bullae on initial CXR or CT, the delayed time frame to onset of pneumothorax could have given rise to pulmonary changes which predisposed him to pneumothorax.…”

Section: Discussionsupporting

confidence: 59%

“… Gonzalez-Pacheco, et al [ 9 ], July 2020, Mexico City, Mexico 1 45 Male Nil Bilateral pneumothorax Chest tubes Recovered and discharged 24. Al-Shokri SD, et al [ 28 ], July 2020, Doha, Qatar 1/3 50 Male Not reported Right tension pneumothorax Chest tube Recovered and transferred 25. Sahu KK, et al [ 29 ], August 2020, Massachusetts, USA 1 61 Male Hypertension Pneumomediastinum, pneumopericardium, subcutaneous emphysema Intubation Expired 26.…”

Section: Discussionmentioning

confidence: 99%

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Case report: Spontaneous pneumothorax in resolved, uncomplicated COVID-19 Pneumonia-A literature review

Dennison¹,

Carlson²,

Faehling³

et al. 2020

Respiratory Medicine Case Reports

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Case report: Spontaneous pneumothorax in resolved, uncomplicated COVID-19 Pneumonia-A literature review

Dennison¹,

Carlson²,

Faehling³

et al. 2020

Respiratory Medicine Case Reports

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“…Conversely, these complications have not been reported when NIV was used for the treatment of common pneumonia patients 6,7 . Some cases of PNX and PNM have been recently reported in patients with COVID-19 pneumonia, most of them spontaneous [12][13][14] , in some cases related to NIV 15,16 or endotracheal intubation (ETI) 17,18 .…”

Section: During This Novel Coronavirus Pandemic Non-invasive Ventilation (Niv) and Continuous Positivementioning

confidence: 99%

Correlation between continuous Positive end-expiratory pressure (PEEP) values and occurrence of Pneumothorax and Pneumomediastinum in SARS-CoV2 patients during non-invasive ventilation with Helmet

Gidaro

Samartin

Brambilla

et al. 2020

Preprint

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Background: Acute Hypoxemic Respiratory Failure (AHRF) is a common complication of Covid-19 related pneumonia, for which non-invasive ventilation (NIV) with Helmet Continuous Positive Airway Pressure (CPAP) is widely used. During past epidemics of SARS and MERS pneumomediastinum (PNM) and pneumothorax (PNX) were common complications (respectively 1.7-12% and 16,4%) either spontaneous or associated to ventilation. Methods: Aim of our retrospective study was to investigate the incidence of PNX/PNM in COVID-19 pneumonia patients treated with CPAP. Moreover, we examined the correlation between PNX/PNM and Positive end-expiratory pressure (PEEP) values. We collected data from patients admitted to Luigi Sacco University Hospital of Milan from 21/02/2020 to 06/05/2020 with COVID-19 pneumonia requiring CPAP. Results: One-hundred-fifty-four patients were enrolled. During hospitalization 3 PNX and 2 PNM occurred (3.2%). Out of these five patients 2 needed invasive ventilation after PNX, two died. In the overall population, 42 patients (27%) were treated with High-PEEP (>10 cmH2O), and 112 with Low-PEEP (≤10 cmH2O). All the PNX/PNM occurred in the High-PEEP group (5/37 vs 0/112, p<0,001). Conclusion: The incidence of PNX appears to be lower in COVID-19 than SARS and MERS, but their occurrence is accompanied by high mortality and worsening of clinical conditions. Considering the association of PNX/PNM with high PEEP we suggest using the lower PEEP as possible to prevent these complications.

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“…The literature describes patients who developed pneumothorax at different stages of the disease course. Al-Shokri et al 18 reported three cases of SARS-CoV-2 infection complicated by pneumothorax. The first, second, and third patient developed pneumothorax on days 2, 7, and 15, respectively.…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax in a patient with pneumonia caused by SARS-CoV-2: A case report

Novkovic

Čekerevac

2021

VOJNOSANIT PREGL

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Introduction. Coronavirus disease 2019 (COVID-19) is acute infectious multisystem disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is manifested by acute respiratory symptoms. Novel coronavirus pneumonia (NCP) is the most common serious clinical manifestation of SARS-CoV-2 infection. During severe NCP systemic manifestations of the disease were also demonstrated, and one of the rare complications, first described in Wuhan (China), is pneumothorax. Case report. A 65-year-old female was admitted to the Pulmonary Clinic with high fever, shortness of breath, sore throat and general weakness that started five days before. Laboratory findings revealed lymphopenia, elevated values of inflammatory markers and liver lesion. A chest X-ray (CXR) demonstrated diffusely accentuated interstitial pattern and reduced parenchymal transparency left parahilar. Positive SARS-CoV-2 in a nasopharyngeal swab sample was detected in the real time-reverse transcription polymerase chain reaction (RT-PCR), confirming the diagnosis of NCP. Immediately, nasal oxygen therapy was initiated flow rate 8 lit/min, chloroquine phosphate, antibiotics, and symptomatic treatment. On day 8, she suddenly deteriorated and developed severe hypoxemia. A repeat CXR showed complete left-sided pneumothorax. Thoracic drainage was successfully performed with complete reexpansion of the lungs the very next day. She was released from the hospital in good general condition with normal arterial blood gases. Conclusion. Pneumothorax may develop as a complication in patients with pneumonia caused SARS-CoV-2, without previous pulmonary comorbidities, due to alveolar damage. Acute deterioration with rapid oxygen desaturation in these patients should raise the suspicion of pneumothorax. Early diagnosis and prompt treatment is necessary to reduce mortality.

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Case Report: COVID-19–Related Pneumothorax—Case Series Highlighting a Significant Complication

Cited by 25 publications

References 14 publications

Case report: Spontaneous pneumothorax in resolved, uncomplicated COVID-19 Pneumonia-A literature review

Case report: Spontaneous pneumothorax in resolved, uncomplicated COVID-19 Pneumonia-A literature review

Correlation between continuous Positive end-expiratory pressure (PEEP) values and occurrence of Pneumothorax and Pneumomediastinum in SARS-CoV2 patients during non-invasive ventilation with Helmet

Pneumothorax in a patient with pneumonia caused by SARS-CoV-2: A case report

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