Faculty Collaboration Database

Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study. Respir Med 2021 Aug;184:106464

Date

05/28/2021

Pubmed ID

34044224

Pubmed Central ID

PMC8116127

DOI

10.1016/j.rmed.2021.106464

Scopus ID

2-s2.0-85106370229 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

BACKGROUND: The clinical features and outcomes of mechanically ventilated patients with COVID-19 infection who develop a pneumothorax has not been rigorously described or compared to those who do not develop a pneumothorax.

PURPOSE: To determine the incidence, clinical characteristics, and outcomes of critically ill patients with COVID-19 infection who developed pneumothorax. In addition, we compared the clinical characteristics and outcomes of mechanically ventilated patients who developed a pneumothorax with those who did not develop a pneumothorax.

METHODS: This study was a multicenter retrospective analysis of all adult critically ill patients with COVID-19 infection who were admitted to intensive care units in 4 tertiary care centers in the United States.

RESULTS: A total of 842 critically ill patients with COVID-19 infection were analyzed, out of which 594 (71%) were mechanically ventilated. The overall incidence of pneumothorax was 85/842 (10%), and 80/594 (13%) in those who were mechanically ventilated. As compared to mechanically ventilated patients in the non-pneumothorax group, mechanically ventilated patients in the pneumothorax group had worse respiratory parameters at the time of intubation (mean PaO₂:FiO₂ ratio 105 vs 150, P<0.001 and static respiratory system compliance: 30ml/cmH₂O vs 39ml/cmH₂O, P = 0.01) and significantly higher in-hospital mortality (63% vs 49%, P = 0.04).

CONCLUSION: The overall incidence of pneumothorax in mechanically ventilated patients with COVID-19 infection was 13%. Mechanically ventilated patients with COVID-19 infection who developed pneumothorax had worse gas exchange and respiratory mechanics at the time of intubation and had a higher mortality compared to those who did not develop pneumothorax.

Author List

Chopra A, Al-Tarbsheh AH, Shah NJ, Yaqoob H, Hu K, Feustel PJ, Ortiz-Pacheco R, Patel KM, Oweis J, Kozlova N, Zouridis S, Ahmad S, Epelbaum O, Chong WH, Huggins JT, Saha BK, Conuel E, Chieng H, Mullins J, Bajaj D, Shkolnik B, Vancavage R, Madisi N, Judson MA

Author

Kurt Hu MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Case-Control Studies
Critical Illness
Female
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Multicenter Studies as Topic
Pneumothorax
Prognosis
Pulmonary Gas Exchange
Respiration, Artificial
Retrospective Studies
Risk Factors