Spontaneous pneumothorax and spontaneous pneumomediastinum in COVID-19 patients.

Abstract

Background: Spontaneous pneumothorax (SP) and or spontaneous pneumomediastinum (SM) are once in a while found clinical complication among the COVID-19 patients. Objectives: This study aims to investigate the occurrence of spontaneous pneumothorax and or spontaneous pneumomediastinum, risk factors, and outcomes among COVID-19 patients. Patients and methods: This is a retrospective chart review of all COVID-19 patients who complicated with a spontaneous pneumothorax and/or spontaneous pneumomediastinum with subcutaneous emphysema from April 2020 to December 2021. Results: A total 49 COVID-19 patients who complicated with a spontaneous pneumothorax and/or spontaneous pneumomediastinum with subcutaneous emphysema were included in the study. Incidence of a SP and/or SM with SC emphysema among ICU admitted COVID-19 patients was 8.03% (49/610) and was 0.98% (49/5000) among all hospitalized COVID-19 patients. The overall mean age was 53.31± 15.36 and most of them were males 33 (67.35%) patients. 31 (63.27%) patients had co-morbidities. We had 24(48.98%) patients with spontaneous pneumothorax without spontaneous pneumomediastinum and subcutaneous emphysema, 17(34.69%) patients had spontaneous pneumothorax with spontaneous pneumomediastinum and subcutaneous emphysema and 8(16.33%) patients had spontaneous pneumomediastinum and subcutaneous emphysema without, Spontaneouspneumothorax.11(22.45%) patients were managed conservatively while right Chest tube was inserted in 16(32.65%) patients, left chest tube was inserted in 9(18.37%) patients and bilateral chest tubes were inserted in 13(26.53%) patients. Total mortality was 33 (67.35%) patients Conclusions: Spontaneous pneumothorax is one of the complications of COVID-19 with a higher mortality rate and worse prognosis.

Keywords

• covid-19; emphysema; pneumomediastinum; pneumonia; pneumothorax