Late-onset pneumothorax in a COVID-19 patient treated with ventilation and ECMO: A case report and literature review

Horii, Toshihiro; Fujioka, Tomoyuki; Takahashi, M.; Mori, M.; Tsuchiya, Junichi; Yamaga, Emi; Yamada, Hirofumi; Kimura, Mizuki; Kishino, Mitsuhiro; Tateishi, Ukihide

doi:10.1016/j.radcr.2020.09.036

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…16 Multiple studies indicated that PNX usually develops at a relatively late stage (3-8 weeks) after the onset of symptoms. 45,46 In a study by Capaccione et al, the time from intubation to PNX event was 14.9 days which is similar to that described by Belletti et al, in which the time from intubation to PNX was 14 days. 15,28 Most patients who developed PBT in our study died (88%).…”

supporting

confidence: 75%

Pulmonary Barotrauma in COVID-19 Patients: Invasive versus Noninvasive Positive Pressure Ventilation

Hamouri¹,

Samrah²,

Albawaih³

et al. 2021

IJGM

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This study aims to determine the incidence and outcome of COVID-19 patients who required positive pressure ventilation (PPV) and subsequently developed pulmonary barotrauma (PBT). Also, to investigate the risk factors and predictors of these complications to better understand the disease pathogenesis. Patients and Methods: This retrospective analysis enrolled all adult COVID-19 patients admitted through the period from October 1, 2020, to December 31, 2020. All patients who received any form of PPV were included. Patients were then divided into two groups based on PBT development, including subcutaneous emphysema, pneumothorax, and pneumomediastinum. Medical records of all patients were reviewed. Patients' demographics, laboratory data on admission, respiratory support modes, surgical interventions, and outcomes were collected and analyzed. Results: In the specified period, 1095 patients were hospitalized due to COVID-19 illness. A total of 239 (21.8%) of all admitted patients received PPV. PBT accounted for 21.3% (51/ 239) of the study cohort. While both groups were equally exposed to the same modes of PPV, receiving invasive ventilation significantly correlated with decreased PBT odds (OR = 0.891; 95% CI, 0.803-0.988; p=0.029). PBT patients were significantly younger (p<0.001). Diabetes mellitus was found to have a protective effect on developing PBT (OR = 0.867; 95% CI, 0.782-0.962), while PO 2 /FIO 2 ratio was inversely associated with higher odds of developing PBT in both univariate and multivariate analyses (p=0.03 and p=0.019, respectively). Conclusion: COVID-19-infected patients are at a higher risk of developing PBT. Invasive positive pressure ventilation was associated with less PBT compared to noninvasive ventilation and delaying intubation does not seem to reduce the risk of pulmonary barotrauma.

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supporting

confidence: 75%

Pulmonary Barotrauma in COVID-19 Patients: Invasive versus Noninvasive Positive Pressure Ventilation

Hamouri¹,

Samrah²,

Albawaih³

et al. 2021

IJGM

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“…The mean time for diagnosis of pneumothorax was 11.63 days. Some studies have reported the presence of pneumothorax at the time of first contact with healthcare facility 7 – 13 while others have reported its development as late as 56 days 14 from the onset of symptoms ( Table 1 and Fig. 4 ).…”

Section: R Esultsmentioning

confidence: 99%

Risk Factors, Clinical Characteristics, and Outcome of Air Leak Syndrome in COVID-19: A Systematic Review

Singh¹,

Singh²,

Pangasa³

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Introduction Air leak consisting of pneumothorax, pneumomediastinum, and subcutaneous emphysema has been described as one of the complications of coronavirus disease-2019 (COVID-19) infection affecting disease course and outcome. We aimed to conduct a systematic review of published literature to highlight the risk factors, types, and outcomes in COVID-19. Method A systematic search of PubMed, Embase, Scopus, and Google Scholar was performed from November 1, 2019, to February 28, 2021. Seventy-one studies fulfilled the inclusion criteria and 136 adult patients were included in the final analysis. Results Majority of patients were male (75.2%) with the mean age of 58 years. Hypertension was the most common comorbidity followed by diabetes mellitus. Moreover, 12.5% of patients had a history of smoking while 11.7% had preexisting lung disease. Isolated pneumothorax (48.5%) was the most common and 17.65% had developed spontaneous pneumothorax. Mean onset time was 11.6 days and 67% of patients required an intercostal drainage tube for management. Mortality was 40%, and elderly, female gender, obese and hypertensive were at higher risk. Conclusion COVID-19-related air leaks are associated with higher mortality and longer hospital stay and can occur even without positive pressure ventilation. History of smoking and preexisting lung disease has not been shown to increase the incidence of air leak. A well-designed study is required for a better understanding of COVID-19-related air leak. How to cite this article Singh A, Singh Y, Pangasa N, Khanna P, Trikha A. Risk Factors, Clinical Characteristics, and Outcome of Air Leak Syndrome in COVID-19: A Systematic Review. Indian J Crit Care Med 2021;25(12):1434–1445.

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“…Frequency of lung imaging abnormalities per different evaluation setting. References [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] are cited in the Supplementary Materials…”

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confidence: 99%

A Systematic Review of Chest Imaging Findings in Long COVID Patients

Bazdar

Kwee

Houweling

et al. 2023

JPM

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Long COVID is the persistence of one or more COVID-19 symptoms after the initial viral infection, and there is evidence supporting its association with lung damage. In this systematic review, we provide an overview of lung imaging and its findings in long COVID patients. A PubMed search was performed on 29 September 2021, for English language studies in which lung imaging was performed in adults suffering from long COVID. Two independent researchers extracted the data. Our search identified 3130 articles, of which 31, representing the imaging findings of 342 long COVID patients, were retained. The most common imaging modality used was computed tomography (CT) (N = 249). A total of 29 different imaging findings were reported, which were broadly categorized into interstitial (fibrotic), pleural, airway, and other parenchymal abnormalities. A direct comparison between cases, in terms of residual lesions, was available for 148 patients, of whom 66 (44.6%) had normal CT findings. Although respiratory symptoms belong to the most common symptoms in long COVID patients, this is not necessarily linked to radiologically detectable lung damage. Therefore, more research is needed on the role of the various types of lung (and other organ) damage which may or may not occur in long COVID.

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Late-onset pneumothorax in a COVID-19 patient treated with ventilation and ECMO: A case report and literature review

Cited by 9 publications

References 14 publications

Pulmonary Barotrauma in COVID-19 Patients: Invasive versus Noninvasive Positive Pressure Ventilation

Pulmonary Barotrauma in COVID-19 Patients: Invasive versus Noninvasive Positive Pressure Ventilation

Risk Factors, Clinical Characteristics, and Outcome of Air Leak Syndrome in COVID-19: A Systematic Review

A Systematic Review of Chest Imaging Findings in Long COVID Patients

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