Journal of Clinical Medicine (Nov 2022)
Prognosis of Spontaneous Pneumothorax/Pneumomediastinum in Coronavirus Disease 2019: The CoBiF Score
- Wongi Woo,
- Vincent Kipkorir,
- Adina Maria Marza,
- Shadi Hamouri,
- Omar Albawaih,
- Arkadeep Dhali,
- Wooshik Kim,
- Zarir F. Udwadia,
- Abdulqadir J. Nashwan,
- Nissar Shaikh,
- Alessandro Belletti,
- Giovanni Landoni,
- Diego Palumbo,
- Sarya Swed,
- Bisher Sawaf,
- Danilo Buonsenso,
- Inês Pimenta,
- Filipe André Gonzalez,
- Giuseppe Fiorentino,
- Muhammad Redzwan S. Rashid Ali,
- Alvaro Quincho-Lopez,
- Mohammad Javanbakht,
- Ayat Alhakeem,
- Muhammad Mohsin Khan,
- Sangam Shah,
- Moezedin Javad Rafiee,
- Sri Rama Ananta Nagabhushanam Padala,
- Sebastian Diebel,
- Seung Hwan Song,
- Du-young Kang,
- Duk Hwan Moon,
- Hye Sun Lee,
- Juyeon Yang,
- Luke Flower,
- Dong Keon Yon,
- Seung Won Lee,
- Jae Il Shin,
- Sungsoo Lee,
- International COVID-19 Pneumothorax Working Group (ICP-WG)
Affiliations
- Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Vincent Kipkorir
- Department of Human Anatomy, School of Medicine, University of Nairobi, Nairobi 00100, Kenya
- Adina Maria Marza
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Shadi Hamouri
- Department of General Surgery & Urology, King Abdullah University Hospital, Jordan University of Science & Technology, Irbid 22110, Jordan
- Omar Albawaih
- Department of General Surgery & Urology, King Abdullah University Hospital, Jordan University of Science & Technology, Irbid 22110, Jordan
- Arkadeep Dhali
- Institute of Postgraduate Medical Education and Research, Kolkata 700020, India
- Wooshik Kim
- Department of Thoracic and Cardiovascular Surgery, National Medical Center, Seoul 04564, Republic of Korea
- Zarir F. Udwadia
- Breach Candy Hospital and Research Center, Mumbai 400026, India
- Abdulqadir J. Nashwan
- Critical Care Department, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha 576214, Qatar
- Nissar Shaikh
- Surgical Intensive Care Department, Hamad General Hospital (HGH), Hamad Medical Corporation (HMC), Doha 576214, Qatar
- Alessandro Belletti
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Diego Palumbo
- Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo 15310, Syria
- Bisher Sawaf
- Department of Internal Medicine, Hamad General Hospital, Doha 576214, Qatar
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy
- Inês Pimenta
- Intensive Care Department, Hospital Garcia de Orta EPE, 2805-267 Almada, Portugal
- Filipe André Gonzalez
- Intensive Care Department, Hospital Garcia de Orta EPE, 2805-267 Almada, Portugal
- Giuseppe Fiorentino
- Sub-Intensive Care Unit and Respiratory Physiopathology Department, Cotugno-Monaldi Hospital, 80131 Naples, Italy
- Muhammad Redzwan S. Rashid Ali
- Kpj Johor Specialist Hospital, Johor Bahru 80100, Malaysia
- Alvaro Quincho-Lopez
- Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima 15024, Peru
- Mohammad Javanbakht
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran
- Ayat Alhakeem
- Hamad Medical Corporation, Doha 576214, Qatar
- Muhammad Mohsin Khan
- Hamad Medical Corporation, Doha 576214, Qatar
- Sangam Shah
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 44618, Nepal
- Moezedin Javad Rafiee
- Babak Imaging Center, Tehran 1415943953, Iran
- Sri Rama Ananta Nagabhushanam Padala
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal 462026, India
- Sebastian Diebel
- Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada
- Seung Hwan Song
- Department of Thoracic and Cardiovascular Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea
- Du-young Kang
- Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul 03063, Republic of Korea
- Duk Hwan Moon
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Luke Flower
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
- Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447, Republic of Korea
- Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
- Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- International COVID-19 Pneumothorax Working Group (ICP-WG)
- DOI
- https://doi.org/10.3390/jcm11237132
- Journal volume & issue
-
Vol. 11,
no. 23
p. 7132
Abstract
Objectives: Pneumothorax and pneumomediastinum are associated with high mortality in invasively ventilated coronavirus disease 2019 (COVID-19) patients; however, the mortality rates among non-intubated patients remain unknown. We aimed to analyze the clinical features of COVID-19-associated pneumothorax/pneumomediastinum in non-intubated patients and identify risk factors for mortality. Methods: We searched PubMed Scopus and Embase from January 2020 to December 2021. We performed a pooled analysis of 151 patients with no invasive mechanical ventilation history from 17 case series and 87 case reports. Subsequently, we developed a novel scoring system to predict in-hospital mortality; the system was further validated in multinational cohorts from ten countries (n = 133). Results: Clinical scenarios included pneumothorax/pneumomediastinum at presentation (n = 68), pneumothorax/pneumomediastinum onset during hospitalization (n = 65), and pneumothorax/pneumomediastinum development after recent COVID-19 treatment (n = 18). Significant differences were not observed in clinical outcomes between patients with pneumomediastinum and pneumothorax (±pneumomediastinum). The overall mortality rate of pneumothorax/pneumomediastinum was 23.2%. Risk factor analysis revealed that comorbidities bilateral pneumothorax and fever at pneumothorax/pneumomediastinum presentation were predictors for mortality. In the new scoring system, i.e., the CoBiF system, the area under the curve which was used to assess the predictability of mortality was 0.887. External validation results were also promising (area under the curve: 0.709). Conclusions: The presence of comorbidity bilateral pneumothorax and fever on presentation are significantly associated with poor prognosis in COVID-19 patients with spontaneous pneumothorax/pneumomediastinum. The CoBiF score can predict mortality in clinical settings as well as simplify the identification and appropriate management of patients at high risk.
Keywords
