Outcomes of patients with COVID-19 pneumonia requiring lung resections in a third-level hospital

Abstract

Abstract Introduction Currently, there is little evidence on the surgical management of pulmonary complications of COVID-19 pneumonia. This study aimed to give insight into common complications arising in patients with COVID-19 pneumonia that require lung resections. Methods This is a retrospective single-center study looking at conditions arising in patients with COVID-19 pneumonia who required lung resection for resolution between March 2020 and March 2021. Clinical presentation, indications to undergo surgery, and factors associated with increased mortality were analyzed. Analysis of nominal variables was performed using nonparametric statistical tests. Results Twelve men (92.3%) and one woman (7.7%) were included in the analysis; the age of included participants ranged from 27 to 72 years, with the mean age being 52. The most common presenting signs and symptoms were dyspnea and tachypnea, which were present in all patients, most common cause for surgery was pneumatocele with 6 cases, followed by lung abscess; patients who underwent surgery because of persistent air leak were more likely to require surgical reintervention (p = 0.005). The overall mortality in our sample was 23%. Increasing age (p = 0.014), myalgias (p = 0.035), elevated D-dimer (p = 0.007), and pulmonary embolism (p = 0.014) were associated with increased mortality. Conclusions Lung resections to treat pulmonary complications in patients with COVID-19 pneumonia appear to be safe, with a survival rate of 77%. Recognizing clinical characteristics such as age, myalgias, elevated D-dimer and pulmonary embolism can aid in identifying those at increased risk.

Keywords

• COVID-19
• Pulmonary resections
• Video-assisted thoracoscopic surgery (VATS)
• Air leak
• Pneumatocele