Spontaneous pneumothorax associated with COVID-19 pneumonia: a single-centre retrospective study

Spontaneous pneumothorax (SP) is a rare complication of COVID-19 pneumonia; it affects both intubated and non-intubated patients. The pathogenesis includes barotrauma and pneumatocele formation. In the following article, we present case series of 18 patients with COVID-19 associated pneumothorax - a detailed demographic and clinical analysis were performed. The study revealed that men were more affected than women, especially above the age of 55 years; whilst, the distribution of intubated patients and those with spontaneous breathing were equal. Importantly, tube thoracostomy was the preferred method of treatment. The lethal outcome was observed in all patients on mechanical ventilation, due to the severe course of the underlying disease. The occurrence of pneumothorax in patients with COVID-19 is associated with poorer outcome of the disease, especially in those placed on mechanical ventilation.

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Bradycardia after Tube Thoracostomy for Spontaneous Pneumothorax

Case Reports in Emergency Medicine ◽

10.1155/2018/6351521 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Yomi Fashola ◽

Sanjeev Kaul ◽

Douglas Finefrock

Keyword(s):

Elderly Patient ◽

Chest Tube ◽

Spontaneous Pneumothorax ◽

Rare Complication ◽

Tube Thoracostomy ◽

Shortness Of Breath ◽

Tube Insertion ◽

Chest Tube Insertion ◽

Severe Bradycardia ◽

Life Threatening

We present the case of an elderly patient who became bradycardic after chest tube insertion for spontaneous pneumothorax. Arrhythmia is a rare complication of tube thoracostomy. Unlike other reported cases of chest tube induced arrhythmias, the bradycardia in our patient responded to resuscitative measures without removal or repositioning of the tube. Our patient, who had COPD, presented with shortness of breath due to spontaneous pneumothorax. Moments after tube insertion, patient developed severe bradycardia that responded to Atropine. In patients requiring chest tube insertion, it is important to be prepared to provide cardiopulmonary resuscitative therapy in case the patient develops a life-threatening arrhythmia.

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Evaluation of the relationship between primary spontaneous pneumothorax and exercise and patient return to previous activities in patients after treatment

GSC Advanced Research and Reviews ◽

10.30574/gscarr.2021.9.2.0125 ◽

2021 ◽

Vol 9 (2) ◽

pp. 008-014

Author(s):

Rastin Hosseinzadeh Asli ◽

Manouchehr Aghajanzadeh ◽

Hossein Hosseinzadeh Asli ◽

Yousha poorahmadi

Keyword(s):

Spontaneous Pneumothorax ◽

Clinical Manifestations ◽

Case Series ◽

Tube Thoracostomy ◽

Primary Spontaneous Pneumothorax ◽

Chi Square ◽

Exercise Time ◽

Exact Test ◽

Significant Difference ◽

The Relationship

Introduction: The most common cause of primary spontaneous pneumothorax (PSP) is sub pleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise time. In this study, wee tend to investigate the relationship between exercise and PSP and time of return to exercise and previous activities. Method: This study was designed as a case series and the sample size included all patients diagnosed with PSP in Razi and Poursina and Aria hospitals of Rasht during 2015-2019 based on inclusion criteria. Variables were analyzed using Fisher's exact test, Chi square, Mann Whitney U and t-test (p<0.05). Results: The most common type of treatment in patients was transaxillary thoracotomy with pleurodesis with iodine (TTP) in 58.2% and tube thoracostomy and pleurodesis in 41.7%, which was not statistically significant between athletes and non-athletes (p=0.806). Athletes who underwent TTP after 4 weeks and those treated with tube thoracostomy and pleurodesis after 8-12 weeks were advised to return to their previous activity. Of athletes, 9.5% had recurrence; of non-athletes, 9.8% had recurrence. Of athletes, 4.8% did not tolerate a return to their previous activity; of non-athletes, 7.3% did not tolerate returning to their previous activity regardless of treatment, and this difference was not significant. Conclusion: Our study showed no significant difference between clinical manifestations and image findings as well as frequency of treatment and complications in both athlete and non-athlete patients. There is no increase in recurrence and intolerance at the time recommended for return to previous activity.

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Pneumothorax in Non-Ventilated COVID-19 Patients: A Case Series

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210628 ◽

2021 ◽

Vol 11 (6) ◽

pp. 178-181

Author(s):

Komal Gharsangi ◽

Rajesh Bhawani ◽

Jitender Sandhu

Keyword(s):

Mechanical Ventilation ◽

Spontaneous Pneumothorax ◽

Structural Changes ◽

Radiological Finding ◽

Case Series ◽

Intrathoracic Pressure ◽

Lung Parenchyma ◽

Average Height ◽

Lung Pathology ◽

Young Males

Coronavirus disease 19 (COVID-19) caused by SARS-CoV-2 has spread worldwide resulting in on-going pandemic. Lung is the most common organ involved in COVID-19 with common radiological finding being ground glass opacities in peripheral distribution and lower lobes.1 Pneumothorax is uncommon feature to observe with COVID-19. The exact incidence of this complication is still not known. In a report by Chen et al. 1% (one patient) had a pneumothorax among other radiographic features.2 In a study published by Yang and colleagues in 92 deceased COVID-19 patients, one (1.1%) had a pneumothorax.3 The mechanism of spontaneous pneumothorax in patients with COVID-19 disease is proposed to be related to the structural changes in the lung parenchyma which include cystic and fibrotic changes leading to alveolar tears. In addition to the increase in intrathoracic pressure resulting from prolonged coughing and/or mechanical ventilation.4,5 Pneumothorax further complicates the case of COVID-19. We present two cases of pneumothorax in young males, average height, non-smokers without any pre-existing lung pathology. Key words: COVID-19, pneumothorax.

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Pneumothorax in COVID-19 disease- incidence and clinical characteristics

Respiratory Research ◽

10.1186/s12931-020-01504-y ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 3

Author(s):

Massa Zantah ◽

Eduardo Dominguez Castillo ◽

Ryan Townsend ◽

Fusun Dikengil ◽

Gerard J. Criner

Keyword(s):

Mechanical Ventilation ◽

Spontaneous Pneumothorax ◽

Clinical Characteristics ◽

Disease Incidence ◽

Rare Complication ◽

Viral Pneumonia ◽

Nasopharyngeal Swab ◽

Peripheral Lung ◽

Hospital Patients ◽

Uncommon Complication

Abstract Background Spontaneous pneumothorax is an uncommon complication of COVID-19 viral pneumonia. The exact incidence and risk factors are still unknown. Herein we review the incidence and outcomes of pneumothorax in over 3000 patients admitted to our institution for suspected COVID-19 pneumonia. Methods We performed a retrospective review of COVID-19 cases admitted to our hospital. Patients who were diagnosed with a spontaneous pneumothorax were identified to calculate the incidence of this event. Their clinical characteristics were thoroughly documented. Data regarding their clinical outcomes were gathered. Each case was presented as a brief synopsis. Results Three thousand three hundred sixty-eight patients were admitted to our institution between March 1st, 2020 and June 8th, 2020 for suspected COVID 19 pneumonia, 902 patients were nasopharyngeal swab positive. Six cases of COVID-19 patients who developed spontaneous pneumothorax were identified (0.66%). Their baseline imaging showed diffuse bilateral ground-glass opacities and consolidations, mostly in the posterior and peripheral lung regions. 4/6 cases were associated with mechanical ventilation. All patients required placement of a chest tube. In all cases, mortality (66.6%) was not directly related to the pneumothorax. Conclusion Spontaneous pneumothorax is a rare complication of COVID-19 viral pneumonia and may occur in the absence of mechanical ventilation. Clinicians should be vigilant about the diagnosis and treatment of this complication.

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Evaluation of the Relationship between Primary Spontaneous Pneumothorax and Exercise and Patient Return to Previous Activities in Patients Referring to Razi and Poursina and Aria Hospitals of Rasht du

Journal of Clinical Surgery and Research ◽

10.31579/2768-2757/011 ◽

2021 ◽

Vol 2 (2) ◽

pp. 01-05

Author(s):

Manouchehr Aghajanzadeh ◽

Mostafa zia ziabari ◽

Mohammad Reza Asgary ◽

Ramin Ebrahimiyan ◽

Ali Alavi Fomani ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Clinical Manifestations ◽

Case Series ◽

Tube Thoracostomy ◽

Primary Spontaneous Pneumothorax ◽

Chi Square ◽

Exercise Time ◽

Exact Test ◽

Significant Difference ◽

The Relationship

Introduction: The most common cause of primary spontaneous pneumothorax (PSP) is sub pleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise time. In this study, we tend to investigate the relationship between exercise and PSP and time of return to exercise and previous activities. Method: This study was designed as a case series and the sample size included all patients diagnosed with PSP in Razi and Poursina and Aria hospitals of Rasht during 2015-2019 based on inclusion criteria. Variables were analyzed using Fisher's exact test, Chi square, Mann Whitney U and t-test (p<0.05). Results: The most common type of treatment in patients was transaxillary thoracotomy with pleurodesis with iodine (TTP) in 58.2% and tube thoracostomy and pleurodesis in 41.7%, which was not statistically significant between athletes and non-athletes (p=0.806). Athletes who underwent TTP after 4 weeks and those treated with tube thoracostomy and pleurodesis after 8-12 weeks were advised to return to their previous activity. Of athletes, 9.5% had recurrence; of non-athletes, 9.8% had recurrence. Of athletes, 4.8% did not tolerate a return to their previous activity; of non-athletes, 7.3% did not tolerate returning to their previous activity regardless of treatment, and this difference was not significant. Conclusion: Our study showed no significant difference between clinical manifestations and image findings as well as frequency of treatment and complications in both athlete and non-athlete patients. There is no increase in recurrence and intolerance at the time recommended for return to previous activity.

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Comparison of Hospital- and Community-Acquired Septic Shock in Children: A Single-Center, Cohort, Retrospective Study

10.21203/rs.3.rs-461185/v1 ◽

2021 ◽

Author(s):

Guoyun Su ◽

Chaonan Fan ◽

Boliang Fang ◽

Zhengde Xie ◽

Suyun Qian

Keyword(s):

Risk Factors ◽

Septic Shock ◽

Mechanical Ventilation ◽

Retrospective Study ◽

Invasive Mechanical Ventilation ◽

Pediatric Intensive Care ◽

Bloodstream Infections ◽

Patient Characteristics ◽

Underlying Disease ◽

Hematological Tumor

Abstract Background To explore differences between hospital- (HASS) and community-acquired septic shock (CASS) in patient characteristics, pathogens, complications, outcomes, and risk factors in pediatric intensive care unit (PICU) children. Methods This retrospective study enrolled septic shock children from January 1, 2016, to December 31, 2019. The patients were followed up until 28 days after shock or death and were divided into HASS and CASS groups. After comparison, logistic regression analyses were used to identify risk factors for mortality. Results A total of 298 children were enrolled. 65.9% of HASS patients (N = 91) had hematological/tumor diseases and were mainly bloodstream infections of Gram-negative bacteria (47.3%). 67.7% of CASS (N = 207) had no obvious underlying disease and were mostly infected with Gram-positive bacteria (30.9%) of the respiratory or central nervous system. 28-day mortality was 62.6% and 32.7% in HASS and CASS groups, respectively (p < 0.001). The factor associated with 28-day mortality of HASS and CASS was MODS (OR:11.524; 95% CI: 2.140-62.051) and needed invasive mechanical ventilation therapy (OR:6.884; 95% CI: 1.499–31.624), respectively. Conclusions The underlying diseases, pathogens, complications, prognosis and mortality varied widely. 28-day mortality is associated with MODS and need for invasive mechanical ventilation therapy in HASS and CASS patients.

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Spontaneous Pneumothorax and Pneumomediastinum in COVID 19: Case Series

International Journal of Anesthesiology Research ◽

10.31907/2310-9394.2021.09.03 ◽

2021 ◽

pp. 8-14

Author(s):

Molano Franco Daniel ◽

◽

Valencia Albert ◽

Nieto Victor ◽

Robayo Ivan ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Subcutaneous Emphysema ◽

Spontaneous Pneumothorax ◽

Prolonged Mechanical Ventilation ◽

Case Series ◽

Spontaneous Pneumomediastinum ◽

Refractory Hypoxemia ◽

Bacterial Superinfection ◽

Worse Prognosis

SARS COV2 infection can produce pneumothorax and spontaneous pneumomediastinum complications, which are associated with a worse prognosis. Here we present a series of cases of patients who presented subcutaneous emphysema caused by pneumothorax or spontaneous pneumomediastinum during care in the intensive care unit for pneumonia and COVID 19. This group of patients showed, in all cases, prolonged mechanical ventilation, refractory hypoxemia and hypercapnia, acute renal failure, bacterial superinfection, need for broad-spectrum antibiotics, and vasopressor support. Keywords: Subcutaneous Emphysema, Spontaneous Pneumothorax, Spontaneous Pneumomediastinum, COVID 19

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