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

Dennison, Jennifer J.; Carlson, Samuel F.; Faehling, Shannon; Lieb, Margaret W.; Mubarik, Ateeq

doi:10.1016/j.rmcr.2020.101291

Cited by 16 publications

(20 citation statements)

References 31 publications

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“…The mean age of our cohort was 63 + 11 yrs with 65% patients being males (Table 1). The duration for the development of barotrauma was 18.5 (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) days from symptom onset and 11 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) days from hospital admission. Interestingly, despite a high incidence of barotrauma, we did not observe CT-based evidence of emphysema, cysts, or bullae.…”

Section: Resultsmentioning

confidence: 99%

“…1 The manifestations of pulmonary barotrauma can range from subcutaneous emphysema (SE) to spontaneous pneumothorax (PTX) and pneumomediastinum (PM). Although uncommonly associated with viral pneumonia, a higher incidence of barotrauma associated with coronavirus disease-2019 (COVID- 19) is being observed. [2][3][4] Based on currently available evidence, the incidence of barotrauma among COVID-19 patients requiring invasive mechanical ventilation ranges from 9%-32%.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation

Rajdev

Spanel

McMillan

et al. 2021

J Intensive Care Med

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Background: We experienced a high incidence of pulmonary barotrauma among patients with coronavirus disease-2019 (COVID-19) associated acute respiratory distress syndrome (ARDS) at our institution. In current study, we sought to estimate the incidence, clinical outcomes, and characteristics of barotrauma among COVID-19 patients receiving invasive and non-invasive positive pressure ventilation. Methodology: We conducted this retrospective cohort study of adult patients diagnosed with COVID-19 pneumonia and requiring oxygen support or positive airway pressure for ARDS who presented to our tertiary care center from March through November, 2020. Results: A total of 353 patients met our inclusion criteria, of which 232patients who required heated high-flow nasal cannula, continuous or bilevel positive airway pressure were assigned to non-invasive group. The remaining 121 patients required invasive mechanical ventilation and were assigned to invasive group. Of the 353 patients, 32 patients (65.6% males) with a mean age of 63 ± 11 years developed barotrauma in the form of either subcutaneous emphysema, pneumothorax, or pneumomediastinum. The incidence of barotrauma was 4.74% (11/232) and 17.35% (21/121) in non-invasive group and invasive group, respectively. The median length of hospital stay was 22 (15.7 −33.0) days with an overall mortality of 62.5% (n = 20). Conclusions: Patients with COVID-19 ARDS have a high incidence rate of barotrauma. Pulmonary barotrauma should be considered in patients with COVID-19 pneumonia who exhibit worsening of their respiratory disease as it is likely associated with a high mortality risk. Utilizing lung-protective ventilation strategies may reduce the risk of barotrauma.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation

Rajdev

Spanel

McMillan

et al. 2021

J Intensive Care Med

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“…However, it was initially decided to perform a native thoracic CT scan, which led to the correct diagnosis and completely changed the patient's therapeutic management, being the first patient with such a complication of SARS-CoV-2 infection in our clinic. As opposed to different case reports from the literature, where the CT scans were performed late in the course of patients' evolution and dictated by the deterioration of the patient, in our case, the CT scan was performed from the admittance to the ED [9,11]. The large availability of CT scan in our hospital helped us to better quantify the overall severity of patients with COVID-19 pneumonia and led to a prompt management of our case.…”

Section: Discussionmentioning

confidence: 95%

“…The timing of SP in the evolution of COVID-19 pneumonia is uncertain. In a recent review of the current literature conducted by Dennison et al on 32 case reports of spontaneous pneumothorax or pneumomediastinum out of 58 COVID-19 pneumonia infections, SP occurred days to weeks after the onset of symptoms [11]. Therefore, issues like risk factors, timing, outcome, still need to be thoroughly researched.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Massive Spontaneous Pneumothorax—A Rare Form of Presentation for Severe COVID-19 Pneumonia

et al. 2021

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Background and Objectives: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a viral disease that is spreading worldwide and became a pandemic. Although most of the time, the symptoms of the infection are flu like, a percentage of patients develop severe forms, along with severe complications. Many of them are known among front-line health workers, but the number of uncommon presentations and complications has increased. This case report aims to alert healthcare workers on less common forms of presentation, and to introduce this differential diagnosis in the evaluation of patients with COVID-19, given the increasing occurrence of pneumothorax in patients who are not mechanical ventilated. Case presentation: A 57-year-old female patient came to the Emergency Department (ED) by ambulance, with acute respiratory failure. She had SpO2 = 43% on room air at home, and 86% on admission in ED after oxygen delivery (on a reservoir mask). SARS-CoV-2 infection was suspected based on symptoms that started three days ago (fever, dry cough, dyspnea, and fatigability). Blood was taken for lab tests, pharyngeal and nasal swabs for the reverse transcription–PCR (RT-PCR) test, and native computed tomography (CT) was scheduled. The thoracic CT scan showed massive right pneumothorax, partially collapsed lung, multiple bilateral lung infiltrates with a ground glass aspect and the RT-PCR test came back positive for SARS-CoV-2 infection. Despite the prompt diagnosis and treatment of pneumothorax (thoracostomy was performed and the drain tube was placed), the patient died after a long hospitalization in the intensive care unit. Conclusion: Secondary spontaneous pneumothorax (SSP), as a complication in severe forms of COVID-19 pneumonia, especially in female patients without risk factors is rare, and early diagnosis and treatment are essential for increasing the survival chances of these patients.

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“…Although a few cases of spontaneous pneumothorax and pneumomediastinum have been reported during the past months [7] , [8] , [9] , [10] , the prognosis of these complications has not been established yet [11] .…”

Section: Discussionmentioning

confidence: 99%

Massive Spontaneous Subcutaneous Emphysema and Pneumomediastinum as Rare Complications of COVID-19 Pneumonia

Maio

Esposito

Margonato

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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

Cited by 16 publications

References 31 publications

Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation

Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation

Case Report: Massive Spontaneous Pneumothorax—A Rare Form of Presentation for Severe COVID-19 Pneumonia

Massive Spontaneous Subcutaneous Emphysema and Pneumomediastinum as Rare Complications of COVID-19 Pneumonia

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