High incidence and mortality of pneumothorax in critically Ill patients with COVID-19
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Xiao-Hui Wang1, Jun Duan1, Xiaoli Han1
1Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, No.1, Youyi Road, Yuzhong District, Chongqing 400016, China.
Background:
The clinical characteristics of the patients with COVID-19 complicated by pneumothorax have not been clarified.
Objectives:
To determine the epidemiology and risks of pneumothorax in the critically ill patients with COVID-19.
Methods:
Retrospectively collecting and analysing medical records, laboratory findings, chest X-ray and CT images of 5 patients complicated by pneumothorax.
Results:
The incidence of pneumothorax was 10% (5/49) in patients with ARDS, 24% (5/21) in patients receiving mechanical ventilation, and 56% (5/9) in patients requiring invasive mechanical ventilation, with 80% (4/5) patients died. All the 5 patients were male and aged ranging from 54 to 79 years old. Pneumothorax was most likely to occur 2 weeks after the beginning of dyspnea and associated with reduction of neuromuscular blockers, recruitment maneuver, severe cough, changes of lung structure and function.
Conclusions:
Pneumothorax is a frequent and fatal complication of critically ill patients with COVID-19.
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