COVID-19 pneumonitis and cystic lung disease, pneumothorax and pneumomediastinum

Everden, Serenydd; Zaki, Irfan; Trevelyan, Gareth; Briggs, James

doi:10.1136/thoraxjnl-2021-217390

Cited by 8 publications

(5 citation statements)

References 3 publications

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“…Interestingly, in this case, our patient was found to have large cystic parenchymal changes on CT. Similar cystic lesions have been identified in patients with COVID-19, though these are typically found in the setting of severe infection, and it is unclear whether they are mediated by direct viral injury or whether this is secondary to factors such as prolonged mechanical ventilation, acute respiratory distress syndrome, or underlying lung disease [ 8 - 9 ]. While our patient did not have prior cross-sectional imaging, it is believed that his cystic parenchymal findings were new and secondary to his COVID-19 infection following comparison with other documented cases in which imaging before COVID-19 infection was normal [ 8 ].…”

Section: Discussionmentioning

confidence: 97%

Spontaneous Pneumothorax as a Late Complication of Mild COVID-19 Infection: A Case Report

Love¹,

Chenyek²,

Osta³

2022

Cureus

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Spontaneous pneumothorax (PTX) is a rare but life-threatening complication of lung injuries sustained from severe COVID-19 infection, most commonly associated with mechanical ventilation. Development of spontaneous PTX in patients after only mild COVID-19 infections not requiring hospitalization is even rarer. Here, we present the case of a 37-year-old male with spontaneous PTX secondary to a mild COVID-19 infection diagnosed one-month prior. A computed tomography (CT) scan of the chest revealed new air-filled cysts thought to be mediated by the inflammatory response to his acute infection, and his PTX was thought to be secondary to cyst wall rupture due to prolonged coughing. He was successfully treated with a chest tube and supplemental oxygen and, at a two-month follow-up, demonstrated clinical and radiographic improvement.

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Section: Discussionmentioning

confidence: 97%

Spontaneous Pneumothorax as a Late Complication of Mild COVID-19 Infection: A Case Report

Love¹,

Chenyek²,

Osta³

2022

Cureus

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“…The mechanism underlying the pathogenesis of PNx/PMEx in COVID-19 remains obscure, and several hypotheses, including air leakage through the alveolar walls [ 26 ], increased vulnerability to PNx/PMEx arising from cyst formation due to severe damage induced by inflammation [ 27 , 28 ], and the Macklin effect as a cause for PMEx, have been postulated [ 29 ]. However, recent studies found no difference between the histopathologic findings of COVID-19 and other causes of lung injury [ 28 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Spontaneous Pneumothorax/Pneumomediastinum in Coronavirus Disease 2019: The CoBiF Score

Woo¹,

Kipkorir²,

Marza³

et al. 2022

JCM

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Objectives: Pneumothorax and pneumomediastinum are associated with high mortality in invasively ventilated coronavirus disease 2019 (COVID-19) patients; however, the mortality rates among non-intubated patients remain unknown. We aimed to analyze the clinical features of COVID-19-associated pneumothorax/pneumomediastinum in non-intubated patients and identify risk factors for mortality. Methods: We searched PubMed Scopus and Embase from January 2020 to December 2021. We performed a pooled analysis of 151 patients with no invasive mechanical ventilation history from 17 case series and 87 case reports. Subsequently, we developed a novel scoring system to predict in-hospital mortality; the system was further validated in multinational cohorts from ten countries (n = 133). Results: Clinical scenarios included pneumothorax/pneumomediastinum at presentation (n = 68), pneumothorax/pneumomediastinum onset during hospitalization (n = 65), and pneumothorax/pneumomediastinum development after recent COVID-19 treatment (n = 18). Significant differences were not observed in clinical outcomes between patients with pneumomediastinum and pneumothorax (± pneumomediastinum). The overall mortality rate of pneumothorax/pneumomediastinum was 23.2%. Risk factor analysis revealed that comorbidities bilateral pneumothorax and fever at pneumothorax/pneumomediastinum presentation were predictors for mortality. In the new scoring system, i.e., the CoBiF system, the area under the curve which was used to assess the predictability of mortality was 0.887. External validation results were also promising (area under the curve: 0.709). Conclusion: The presence of comorbidity bilateral pneumothorax and fever on presentation are significantly associated with poor prognosis in COVID-19 patients with spontaneous pneumothorax/pneumomediastinum. The CoBiF score can predict mortality in clinical settings as well as simplify the identification and appropriate management of patients at high risk.

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“…We argue therefore, that if a patient is known to have extensive cystic changes on CT, it is important to consider that they may deteriorate rapidly post discharge secondary to a complication from cyst rupture. Complications may include, pneumatoceles 5 , pneumothoraces, and pneumomediastinums 2,6 .…”

Section: Joynt Et Al Summarized the Radiological Findings Into Two Groups As Followsmentioning

confidence: 99%

“…Cystic CT changes in the context of covid-19 pneumonia have been observed to progress into pneumatoceles, pneumothoraces, and more rarely pneumomediastiums 2,6 , with approximately 1% of covid-19 infections developing pneumothoraces 2 . However, it is important to acknowledge that the majority of cysts remain asymptomatic and are not (yet) known to result in long term complications.…”

Section: Joynt Et Al Summarized the Radiological Findings Into Two Groups As Followsmentioning

confidence: 99%

Commentary: Covid-19 Pneumonitis and Cystic Lung Disease, Pneumothorax and Pneumomediastinum

West¹

2021

J Lung Health Dis

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COVID-19 pneumonitis and cystic lung disease, pneumothorax and pneumomediastinum

Cited by 8 publications

References 3 publications

Spontaneous Pneumothorax as a Late Complication of Mild COVID-19 Infection: A Case Report

Spontaneous Pneumothorax as a Late Complication of Mild COVID-19 Infection: A Case Report

Prognosis of Spontaneous Pneumothorax/Pneumomediastinum in Coronavirus Disease 2019: The CoBiF Score

Commentary: Covid-19 Pneumonitis and Cystic Lung Disease, Pneumothorax and Pneumomediastinum

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