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Air leak with COVID-19 - A meta-summary
Prashant Nasa1, Deven Juneja2, Ravi Jain3
1Department of Critical Care Medicine, NMC Specialty Hospital, Dubai, United Arab Emirates.
Asian Cardiovascular & Thoracic Annals
|July 12, 2021
Summary
Air leaks, including pneumothorax, can occur in coronavirus disease 2019 (COVID-19) patients even without mechanical ventilation. Mortality risk significantly increases when air leaks develop alongside positive pressure ventilation or require advanced respiratory support.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Infectious Diseases
Background:
- Reports indicate a correlation between coronavirus disease 2019 (COVID-19) and air leaks.
- A systematic review was conducted to analyze the types and outcomes of air leaks in COVID-19 patients.
Purpose of the Study:
- To systematically review and analyze the types of air leaks in COVID-19 patients.
- To investigate the outcomes associated with different types of air leaks in COVID-19.
Main Methods:
- A comprehensive literature search was performed on PubMed, Science Direct, and Google Scholar from the pandemic's start until March 31, 2021.
- Included studies were case reports or series of laboratory-confirmed SARS-CoV-2 infection with detailed patient data and diagnosed air leak syndromes.
Main Results:
- 105 studies involving 188 patients were analyzed. Pneumothorax was the most frequent air leak (68%).
- Over half of patients (56.7%) required intervention, with intercostal drains being the preferred method (95.9%).
- Mortality was higher in patients with air leaks associated with positive pressure ventilation (49%) and escalated respiratory support (39%).
Conclusions:
- Air leaks in COVID-19 can manifest spontaneously, independent of positive pressure ventilation or pre-existing risk factors.
- Positive pressure ventilation and the need for escalated respiratory support significantly increase mortality risk in COVID-19 patients with air leaks.
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