Spontaneous pneumomediastinum and pneumothorax in COVID‐19 patients: A tertiary care experience

Abstract

Introduction COVID‐19 can occasionally complicate into spontaneous pneumothorax (SP) and/or spontaneous pneumomediastinum (SM). This study aims at exploring the occurrence of SP and or SM, risk factors, and outcomes in COVID‐19 patients. Materials and Methods All patients with COVID‐19, which complicated into SP and/or SM at Hamad Medical Corporation (the principal public healthcare provider in Qatar) from March to September 2020, were retrospectively enrolled. The clinical diagnosis was confirmed by CXR and CT. Between‐group comparisons were performed by using Chi‐square and t ‐test. Differences were considered statistically significant at P ≤ .05. Results A total of 1100 patients were admitted, and 43 patients developed SP, SP + SM, or SM. Most patients were males (42/97.9%), and the most common comorbidity was diabetes mellitus (13/30.2%). All patients had acute respiratory distress syndrome (ARDS), and most patients had low lung compliance at the time of developing SP or SM. Twenty‐two of the patients developed SP (51.2%), 11 patients had both SP and SM (25.6%), and 10 patients had SM only (23.3%). There was no significant difference in the development of SP or SM and patients' gender or blood group or whether patients were on invasive or noninvasive ventilation or even the mortality ( P > .05). Lung compliance was significantly ( P < .05) lower in patients complicated with SP and or SM. Patients with SP required significantly higher ( P < .001) chest drain insertion. Conclusion Patients with severe COVID‐19 pneumonia can complicate into SP and SM. These complications are more common in male diabetic patients. Patients with ARDS and having low lung compliance are at a higher risk of developing SP, SP + SM, or SM.

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

“…Its prevalence, risk factors, and final outcome remain unclear. 13,14,[30][31][32][33][34][36][37][38][39] Our research contributes to understanding the combination of SP, SPM and COVID-19 in non-ventilated patients, and quantifying their associated risks for in-hospital mortality.…”

Evaluation of Patients Who Developed Pneumothorax Due to COVID-19

“…As a result of its rapid spread around the world in spite of the various preventive measures that were taken, it was declared a pandemic by the World Health Organization under the name of COVID-19 on 11 March 2020. The COVID-19 pandemic has caused a number of deaths [ 1 , 2 ]. As of 1 April 2022, the number of more than 490 millioncases had been reported around the world, and the number of deaths has exceeded six million ( , accessed on 23 July 2022) [ 3 ].…”

Case Report: COVID-19 With Spontaneous Pneumothorax, Pneumomediastinum and Subcutaneous Emphysema

“…4 Even if the patient does not require any invasive or non-invasive ventilator, these clinical pointers should be assessed to rule out spontaneous pulmonary air-leak syndrome. 5 Here we report an atypical presentation and complication case of pneumothorax, pneumomediastinum, and subcutaneous emphysema associated with COVID-19.…”