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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Epidemiological and outcome analysis of COVID-19-associated pneumothorax: multicentre retrospective critical care
Jaweria Akram1, Zohaib Yousaf2, Yasir Alabbas1
1Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Objectives:
To study the incidence, characteristics, treatment, associated risk factors and outcome of COVID-19-associated pneumothorax in intensive care unit (ICU).
Design:
Retrospective observational data review.
Setting:
A multicentre study from ICUs of three tertiary care hospitals in Qatar.
Participants:
1788 patients with COVID-19 pneumonia requiring ICU admission from 1 March 2020 to 1 November 2020 were enrolled in this study.
Interventions:
Not applicable.
Primary And Secondary Outcome Measures:
The primary endpoint was to identify the incidence of COVID-19-associated pneumothorax in patients requiring ICU admission. Secondary endpoints were to determine the associated risk factors, treatment, mortality and morbidity.
Results:
1788 patients from 3 centres were reviewed in the study. The total episodes of pneumothorax were 75. Pneumothorax occurred in 4.2% of the patients with COVID-19 pneumonia requiring ICU admission. The majority of the subjects were male (n=72, 96%). The mean age was 55.1 (±12.7 years). The majority of the subjects were nationals of South Asian countries and the Middle East and North Africa regions. 52% (n=39) of the patients were previously healthy without comorbidities before ICU admission. The recurrence rate was 9.3%. The median length of ICU stay was 28 days (20.5-45.8 days). After developing pneumothorax, the length of mechanical ventilation ranged from 6 to 32 days, with a median of 13 days. 44% of patients eventually ended up with tracheostomy. In-hospital mortality in the patients with COVID-19-related pneumothorax was 53.3% (n=40). The odds of mortality in patients with COVID-19 pneumonia with pneumothorax is 7.15 (95% CI 4.45 to 11.48, p<0.0001) compared with those who did not develop pneumothorax. This indicates pneumothorax is a potential independent risk factor associated with mortality in patients with COVID-19 pneumonia requiring ICU admission.
Conclusions:
Pneumothorax is a common complication in patients with COVID-19 requiring ICU admission, associated with poor prognosis and outcome.
Trial Registration Number:
The study was approved by the Medical Research Centre (MRC) Qatar. (MRC-01-20-1116).
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