Bilateral spontaneous pneumothorax in critically-ill COVID-19 infants: About two cases
Ilyass Laaribi1,2, Hamza Mimouni1,2, Zakaria Bouayed1,2
1Anesthesia, Intensive Care and Resuscitation Department, MOHAMMED VI University Hospital Center, Oujda, Morocco.
Insights
Spontaneous pneumothorax is a rare but serious complication of COVID-19 in infants. This case series highlights the importance of considering this condition in infants with worsening respiratory symptoms during the pandemic.
Area of Science:
- Pediatric Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- The COVID-19 pandemic presents unique challenges in pediatric care.
- While numerous complications of COVID-19 are documented, spontaneous pneumothorax is infrequently observed, particularly in infants.
Observation:
- This report details two infant cases (9 and 18 months) experiencing acute respiratory distress due to COVID-19, complicated by spontaneous pneumothorax.
- Both infants underwent successful pneumothorax drainage.
- One infant recovered fully, while the other experienced a fatal outcome due to septic shock secondary to a urinary tract infection.
Findings:
- Spontaneous pneumothorax is an uncommon but significant complication of severe COVID-19 in infants.
- The study discusses potential pathogenetic links between COVID-19 and spontaneous pneumothorax, drawing comparisons with adult data.
- The management of spontaneous pneumothorax in infants with COVID-19 involves prompt respiratory support and drainage.
Implications:
- Healthcare providers should maintain a high index of suspicion for spontaneous pneumothorax in infants with COVID-19 exhibiting respiratory deterioration or persistent hypoxia.
- Early recognition and intervention are crucial for managing this complication.
- Further research is needed to fully elucidate the mechanisms and optimize treatment strategies for COVID-19-associated spontaneous pneumothorax in pediatric populations.
Introduction:
COVID-19 is an emerging infection, it is the first large-scale pandemic of the 21st century. Several complications have been described during this infection but spontaneous pneumothorax remains an uncommon complication, even more so in infants.
Clinical Presentation:
We report two cases of a 9-month-old and 18-month-old males admitted to our department for the management of an acute respiratory distress due to a COVID-19 infection associated to a spontaneous pneumothorax successfully drained.While one patient had a favorable outcome, the other was readmitted to our department for the management of a septic shock secondary to a urinary tract infection with a deadly outcome.
Discussion:
In this paragraph we describe known causes behind spontaneous pneumothorax, before detailing the different pathogenesis hypotheses linking pneumothorax to COVID-19, all while comparing data to the literature related to the adult population.
Conclusion:
Spontaneous pneumothorax is a serious complication associated with severe COVID-19 that can occur in infants and must be considered in the event of a respiratory aggravation or a persistent hypoxia.
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