Increased frequency of pneumothorax and pneumomediastinum in COVID-19 patients admitted in the ICU: A multicentre study from Mumbai, India.

Autor: Udwadia ZF; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India zfu@hindujahospital.com., Toraskar KK; Wockhardt Hospital, Mumbai, India., Pinto L; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Mullerpatan J; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Wagh HD; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Mascarenhas JM; Breach Candy Hospital Trust, Mumbai, India., Gandhi BM; Breach Candy Hospital Trust, Mumbai, India., Tripathi A; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Sunavala A; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Agrawal U; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Nanda V; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Abraham N; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Francis B; PD Hinduja National Hospital & Medical Research Centre, Mumbai, India., Zore RR; Wockhardt Hospital, Mumbai, India., Pundpal G; Wockhardt Hospital, Mumbai, India., Gondse B; Wockhardt Hospital, Mumbai, India., Gupta GA; Wockhardt Hospital, Mumbai, India.
Jazyk: angličtina
Zdroj: Clinical medicine (London, England) [Clin Med (Lond)] 2021 Nov; Vol. 21 (6), pp. e615-e619.
DOI: 10.7861/clinmed.2021-0220
Abstrakt: Background: There are limited data regarding the incidence of pneumothorax in COVID-19 patients as well as the impact of the same on patient outcomes.
Methods: A retrospective review of the medical records at three large tertiary care hospitals in Mumbai was performed to identify patients hospitalised with COVID-19 from March 2020 to October 2020. The presence of pneumothorax and/or pneumomediastinum was noted when chest radiographs or CT scans were performed. Demographic and clinical characteristics of patients who developed air leak were recorded.
Results: 4,906 patients with COVID-19 were admitted, with 1,324 (27%) having severe COVID-19 disease. The overall incidence of pneumothorax and/or pneumomediastinum in patients with severe disease was 3.2% (42/1,324). Eighteen patients had pneumothorax, 16 had pneumomediastinum and 8 patients had both. Fourteen patients (33.3%) developed this complication breathing spontaneously, 28 patients (66.6%) developed it during mechanical ventilation. Overall mortality in this cohort was 74%, compared with 17% in the COVID-19 patients without pneumothorax (p<0.001).
Conclusions: Our study demonstrates that air leaks occur with a higher frequency in patients with COVID-19 than in other ICU patients. When present, such air leaks contributed to poor outcomes with almost 74% mortality rates in these patients.
(© Royal College of Physicians 2021. All rights reserved.)
Databáze: MEDLINE
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