Management of spontaneous pneumothorax in patients with COVID-19
| Autor: | Ilham Gulcek, Emine Gulcek, Talat Kilic, Mehmet Agar, Muhammet Reha Çelik, Muhammed Kalkan, Hakki Ulutas |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Respiratory System Thoracostomy Lung injury Oxygen therapy medicine Humans Pandemics business.industry COVID-19 Pneumothorax respiratory system medicine.disease Neutrophilia 1004 Medical Biotechnology 1103 Clinical Sciences respiratory tract diseases Surgery Oxygen Chest tube Pneumonia Chest Tubes Female medicine.symptom Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. 34:1002-1010 |
| ISSN: | 1569-9285 |
| Popis: | OBJECTIVES The coronavirus disease 2019 (COVID-19) pneumonia may cause cystic features of lung parenchyma which can resolve or progress to larger blebs. Pneumothorax was more likely in patients with neutrophilia, severe lung injury and a prolonged clinical course. The timely diagnosis and management will reduce COVID-19-associated morbidity and mortality. METHODS We present 11 cases of spontaneous pneumothorax managed with chest tube thoracostomy or high-dose oxygen therapy. Isolated spontaneous pneumothorax was detected in all cases. RESULTS Eight cases were male and 3 cases were female. There were bilateral ground-glass opacities or pulmonary infiltrates in the parenchyma of the 10 cases. We detected neutrophilia, lymphopaenia and increased C-reactive protein, Ferritin, lactate dehydrogenase, D-Dimer, interleukin-6 levels in almost all cases. Chest tube thoracostomy was sufficient to treat pneumothorax in our 9 of case. In 2 cases, pneumothorax healed with high-dose oxygen therapy. Favipiravir and antibiotic treatment were given to different 10 patients. In our institution, all patients with COVID-19 infection were placed on prophylactic or therapeutic anticoagulation, unless contraindicated. The treatments of patients diagnosed with secondary spontaneous pneumothorax during the pandemic period and those diagnosed with secondary spontaneous pneumothorax in the previous 3 years were compared with the durations of tube thoracostomy performed in both groups. CONCLUSIONS The increased number of cases of pneumothorax suggests that pneumothorax may be a complication of COVID-19 infection. During medical treatment of COVID-19, pneumothorax may be the only reason for hospitalization. Although tube thoracostomy is a sufficient treatment option in most cases, clinicians should be aware of the difficulties that may arise in diagnosis and treatment. |
| Databáze: | OpenAIRE |
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