Delayed recurrent spontaneous pneumothorax post-recovery from COVID-19 infection

Kasturi, Srikanth; Muthirevula, Arvind; Chinthareddy, Rohan Reddy; Lingaraju, Vijay Cholenahalli

doi:10.1007/s12055-021-01145-w

Cited by 13 publications

(11 citation statements)

References 9 publications

(6 reference statements)

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“…First, a prolonged air leak is developed due to the persistent chronic inflammatory changes and a delayed alveolar breach as part of an ongoing chronic disease process. 23 Second, focal endothelitis may cause prolonged healing in the lung parenchyma. 24 Patients in the COVID-recovery group have higher DSS than those with PSP; this supports the hypotheses of the prolonged air leak.…”

Section: Discussionmentioning

confidence: 99%

Should Pneumothorax Developing During the Recovery Period After COVID-19 in Patients with Previously Healthy Lungs be Considered a Primary Spontaneous Pneumothorax or a Secondary Spontaneous Pneumothorax?

Köse¹

2022

Turk Thorac J

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OBJECTIVE: It is still unknown how to call the pneumothorax that develops during the recovery period after coronavirus disease 2019. Patients who developed pneumothorax during the recovery period after coronavirus disease 2019 were compared with those who had a primary or secondary spontaneous pneumothorax without a coronavirus disease 2019 history. MATERIAL AND METHODS: Between 2020 and 2021, 160 patients with pneumothorax were retrospectively analyzed. Twenty-three patients had a history of coronavirus disease 2019 (coronavirus disease recovery) confirmed by real-time reverse transcriptase-polymerase chain reaction, whereas the remaining 137 patients did not have a history of coronavirus disease 2019 (18 of the patients with secondary spontaneous pneumothorax group and 119 patients with primary spontaneous pneumothorax group). Results: The median time between discharge and readmission to the hospital because of pneumothorax was 9 days in the coronavirus disease recovery group. There were statistically significant differences in regards to age ( P < .001), gender ( P = .02), the presence of bullae ( P = .02), and dystrophic severity lung score ( P = .04) between the coronavirus disease recovery and primary spontaneous pneumothorax groups, whereas no difference was found between the coronavirus disease recovery and the secondary spontaneous pneumothorax groups ( P > .05). The prolonged air leak was observed in 17.6% (n = 25). Patients who had prolonged air leak were statistically higher in the coronavirus disease recovery group than the primary spontaneous pneumothorax group (56.5% vs. 10.1%), although it was almost similar between the coronavirus disease recovery and secondary spontaneous pneumothorax groups ( P = .951). On logistic regression analysis, the coronavirus disease recovery group was the independent factor for prolonged air leak (odds ratio = 9.900, 95% CI = 1.557-62.500, P = .01). Conclusion: Pneumothorax may be developed during the recovery period after coronavirus disease 2019 in patients with previously healthy lungs, and it should be called as secondary spontaneous pneumothorax.

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Section: Discussionmentioning

confidence: 99%

Should Pneumothorax Developing During the Recovery Period After COVID-19 in Patients with Previously Healthy Lungs be Considered a Primary Spontaneous Pneumothorax or a Secondary Spontaneous Pneumothorax?

Köse¹

2022

Turk Thorac J

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“…These findings support the hypothesis that structural changes over time may lead to an air-filled cavity kept open by a feeding airway acting as a one-way valve with subsequent formation of large lung bullae ( 22 , 23 ). Multiple cases of delayed parenchymal destruction leading to bullous disease have been reported in the literature, which points toward some form of continued alveolar destructive process or lung parenchymal remodeling ( 16 , 24 , 25 ). Van der Klooster and Grootendorst have proposed that disruption of the protease–antiprotease balance in the lungs may be one of the underlying mechanisms related to cocaine or smoking-induced bullous lung disease, and there is evidence that this mechanism may exist in severe cases of pneumonia ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Bullous Lung Disease Following COVID-19

et al. 2021

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More than 87% of patients report the persistence of at least one symptom after recovery from the Coronavirus disease 2019 (COVID-19). Dyspnea is one of the most frequently reported symptoms following severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection with persistent chest radiological abnormalities up to 3 months after symptom onset. These radiological abnormalities are variable and most commonly include ground-glass opacities, reticulations, mosaic attenuation, parenchymal bands, interlobular septal thickening, bronchiectasis, and fibrotic-like changes. However, in this case report, we describe findings of bullous lung disease as a complication of SARS CoV-2 infection. As the pandemic continues, there is a need to understand the multiple respiratory manifestations of post-acute sequelae of COVID-19. We, therefore, present this case to add to the current body of literature describing pulmonary disease as a consequence of SARS CoV-2 infection.

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“…Spontaneous pneumothoraces were described in only 1% of cases, predominantly in male patients (3.3:1) [10,11]. Delayed pneumothoraces were reported in several cases [12,13]. While the exact process of the development of a delayed pneumothorax remains unknown, persistent chronic inflammatory changes and delayed alveolar damage due to coughing are discussed as a possible cause [14].…”

Section: Discussionmentioning

confidence: 99%

One-year follow-up—case report of secondary tension pneumothorax in a COVID-19 pneumonia patient

Endres¹,

Spiro

Bolt

et al. 2021

Infection

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Purpose The Coronavirus Disease 2019 (COVID-19) may result not only in acute symptoms such as severe pneumonia, but also in persisting symptoms after months. Here we present a 1 year follow-up of a patient with a secondary tension pneumothorax due to COVID-19 pneumonia. Case presentation In May 2020, a 47-year-old male was admitted to the emergency department with fever, dry cough, and sore throat as well as acute chest pain and shortness of breath. Sputum testing (polymerase chain reaction, PCR) and computed tomography (CT) confirmed infection with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Eleven days after discharge, the patient returned to the emergency department with pronounced dyspnoea after coughing. CT showed a right-sided tension pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. For a period of 3 months following resolution of the pneumothorax the patient complained of fatigue with mild joint pain and dyspnoea. After 1 year, the patient did not suffer from any persisting symptoms. The pulmonary function and blood parameters were normal, with the exception of slightly increased levels of D-Dimer. The CT scan revealed only discrete ground glass opacities (GGO) and subpleural linear opacities. Conclusion Tension pneumothorax is a rare, severe complication of a SARS-CoV-2 infection but may resolve after treatment without negative long-term sequelae. Level of evidence V.

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Delayed recurrent spontaneous pneumothorax post-recovery from COVID-19 infection

Cited by 13 publications

References 9 publications

Should Pneumothorax Developing During the Recovery Period After COVID-19 in Patients with Previously Healthy Lungs be Considered a Primary Spontaneous Pneumothorax or a Secondary Spontaneous Pneumothorax?

Should Pneumothorax Developing During the Recovery Period After COVID-19 in Patients with Previously Healthy Lungs be Considered a Primary Spontaneous Pneumothorax or a Secondary Spontaneous Pneumothorax?

Case Report: Bullous Lung Disease Following COVID-19

One-year follow-up—case report of secondary tension pneumothorax in a COVID-19 pneumonia patient

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