| Popis: |
Adina Maria Marza,1,2 Alina Petrica,1,3 Diana Lungeanu,4 Dumitru Sutoi,1,5 Alexandra Mocanu,6 Ioan Petrache,1,7 Ovidiu Alexandru Mederle1,2 1Department of Surgery, âVictor Babesâ University of Medicine and Pharmacy, Timisoara, 300041, Romania; 2Emergency Department, Emergency Clinical Municipal Hospital, Timisoara, 300079, Romania; 3Emergency Department, âPius Brinzeuâ Emergency Clinical County Hospital, Timisoara, 300736, Romania; 4Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, âVictor Babesâ University of Medicine and Pharmacy, Timisoara, 300041, Romania; 5Clinic of Anaesthesia and Intensive Care, âPius Brinzeuâ Emergency Clinical County Hospital, Timisoara, 300736, Romania; 6Department of Infectious Diseases, âVictor Babesâ University of Medicine and Pharmacy, Timisoara, 300041, Romania; 7Clinic of Thoracic Surgery, Emergency Clinical Municipal Hospital, Timisoara, 300079, RomaniaCorrespondence: Alina PetricaDepartment of Surgery, âVictor Babesâ University of Medicine and Pharmacy, Piata Eftimie Murgu 2, Timisoara, 300041, RomaniaTel +40744772427Email alina.petrica@urgentatm.roDiana LungeanuCenter for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, âVictor Babesâ University of Medicine and Pharmacy, Piata Eftimie Murgu 2, Timisoara, 300041, RomaniaEmail dlungeanu@umft.roBackground and Objectives: Spontaneous pneumothorax (SP) and spontaneous pneumomediastinum (SPM) have frequently been cited as complications associated with coronavirus disease 2019 (COVID-19) pneumonia, with especially poor prognosis in mechanically ventilated patients. The current literature is controversial regarding the potential risk factors for developing SP or SPM (SP-SPM) in non-ventilated COVID-19 patients. Our research addressed a twofold objective: (a) to investigate the characteristics of patients with SP-SPM (both with and without COVID-19) and compare them to patients with sole COVID-19; (b) to quantify the risk of in-hospital mortality associated with SP-SPM and COVID-19.Patients and Methods: A retrospective caseâcontrol study was conducted in the emergency departments (ED) of two tertiary hospitals in Timisoara, Romania, over one year (1st April 2020â31st March 2021; 64,845 records in total) and 70 cases of SP-SPM were identified (both SARS-CoV-2 positives and negatives). The control group comprised COVID-19 patients with no SP-SPM, included at a 2:1 ratio. Logistic regression was employed to quantify the in-hospital mortality risk associated with age, SP-SPM, and COVID-19.Results: SP-SPM and COVID-19 were connected with prolonged hospitalization, a higher percentage of intensive care admission, and a higher mortality. SP-SPM increased the odds of death by almost four times in patients of the same age, gender, smoking status, and SARS-CoV-2 infection: OR = 3.758, 95% CI (1.443â 9.792). Each additional year of age added 9.4% to the mortality risk: OR = 1.094, 95% CI (1.054â 1.135).Conclusion: ED physicians should acknowledge these potential risks when attending COVID-19 patients with SP-SPM.Keywords: caseâcontrol study, in-hospital mortality, chest pain, dyspnea, chest CT, COVID-19 |
