Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case–control study

Autor: Se Ju Lee, Jinnam Kim, Ki Hyun Lee, Jung Ah Lee, Chang Hyup Kim, Su Hwan Lee, Byung Jo Park, Jung Ho Kim, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Joon-Sup Yeom, Jun Yong Choi
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Infectious Diseases, Vol 23, Iss 1, Pp 1-9 (2023)
Druh dokumentu: article
ISSN: 1471-2334
DOI: 10.1186/s12879-023-08104-3
Popis: Abstract Background During the novel coronavirus disease-2019 pandemic, a considerable number of pneumothorax (PNX)/pneumomediastinum (PNM) associated with COVID-19 have been reported, and the incidence is higher in critically ill patients. Despite using a protective ventilation strategy, PNX/PNM still occurs in patients on invasive mechanical ventilation (IMV). This matched case–control study aims to identify the risk factors and clinical characteristics of PNX/PNM in COVID-19. Methods This retrospective study enrolled adult patients with COVID-19, admitted to a critical care unit from March 1, 2020, to January 31, 2022. COVID-19 patients with PNX/PNM were compared, in a 1–2 ratio, to COVID-19 patients without PNX/PNM, matched for age, gender, and worst National Institute of Allergy and Infectious Diseases ordinal scale. Conditional logistic regression analysis was performed to assess the risk factors for PNX/PNM in COVID-19. Results 427 patients with COVID-19 were admitted during the period, and 24 patients were diagnosed with PNX/PNM. Body mass index (BMI) was significantly lower in the case group (22.8 kg/m2 and 24.7 kg/m2; P = 0.048). BMI was statistically significant risk factor for PNX/PNM in univariate conditional logistic regression analysis [odds ratio (OR), 0.85; confidence interval (CI), 0.72–0.996; P = 0.044]. For patients on IMV support, univariate conditional logistic regression analysis showed the statistical significance of the duration from symptom onset to intubation (OR, 1.14; CI, 1.006–1.293; P = 0.041). Conclusions Higher BMI tended to show a protective effect against PNX/PNM due to COVID-19 and delayed application of IMV might be a contributive factor for this complication.
Databáze: Directory of Open Access Journals
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