Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy
| Autor: | Marcello Rattazzi, Marta Tiepolo, Marina Saetta, Simonetta Baraldo, Matteo Bonato, Giuseppe Zanardi, Mario Peta, Francesca Savoia, Emanuela Rossi, Alessia Pauletti, Riccardo Adami, Fabiola Zeraj, Silvia Galvan, Giovanni Morana, Vito Catalanotti, Elisabetta Marcon, Francesca Zampieri, Nicola Malacchini, Nicholas Landini, Piera Peditto, Mauro Salasnich, Maria Cuzzola, Alessia Fraccaro, Micaela Romagnoli, Cosimo Catino |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
ARDS Coronavirus disease 2019 (COVID-19) pneumothorax coronavirus North east Article Internal medicine medicine Pneumomediastinum case-control COVID-19 pneumomediastinum SARS-CoV-2 business.industry Incidence (epidemiology) Case-control study General Medicine medicine.disease Pneumothorax Respiratory failure Medicine business |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 21 Journal of Clinical Medicine, Vol 10, Iss 4835, p 4835 (2021) |
| ISSN: | 2077-0383 |
| Popis: | Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients’ outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. Methods: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX/PNM were compared. Results: Among 1213 patients, PNX and/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX/PNM showed higher in-hospital (p = 0.02) and 90-days mortality (p = 0.048), and longer hospitalization length (p = 0.002) than COVID-19 patients without PNX/PNM. At PNX/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX/PNM occurrence was associated with longer symptom length before hospital admission (p = 0.005) and lower levels of blood lymphocytes (p = 0.017). Conclusion: PNX/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation. |
| Databáze: | OpenAIRE |
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