Pneumothorax in Coronavirus Disease-19 Patients: A Retrospective Case Series

Abstract

Objective: Pneumothorax may develop secondary to alveolar damage and barotrauma in Covid-19 patients. In this study, in the light of the literature. we aimed to present Covid-19 patients who developed pneumothorax among whom we followed up in the intensive care unit. Methods: Eleven patients among 2680 patients tested positive for Covid-19 in the PCR test and developed pneumothorax in the radiologic examination were included in the study. The data were obtsined from patient follow-up forms and electronic medical records. Demographic data, blood and biochemical parameters, blood culture results, time and location of development of pneumothorax, modality, and duration of pneumothorax treatment, and mortality data were recorded. Results: The frequency of development of pneumothorax was found to be 0.41%. The most common complaint was dyspnea. Comorbidiites were observed in 9 (81.8%) patients and the most common comorbidity was hypertension. It was determined that 3 (27.2%) patients did not smoke, 4 patients(36.3%) were active smokers, and 4 (36.3%) patients were ex-smokers. The mean age was 69±14.8 years, the APACHE II score were 18.8±8.7, the female/male ratio was 3/8, and the the time to pneumothorax development was 10.7±11.8 days. Pneumothorax developed in 3 (27.27%) patients on noninvasive mechanical ventilation and 8 (72.7%) patients on invasive mechanical ventilation. The mean length of stay in the intensive care unit was 21.6±26.5 days. It was found that 10 (90.9%) patients died and the mean time to mortality was 19.5±27.0 days. Conclusion:In Covid-19 infection, lung protective ventilation strategies should be adopted and it should be known that the development of pneumothorax is a late complication that increases mortality and morbidity.