1. Pneumothorax, pneumomediastinum, and subcutaneous emphysema in hospitalized COVID-19 patients: incidence, clinical characteristics, and outcomes.
- Author
-
Murawska Baptista A, Sinclair De Frías J, Singh T, Vasudhar A, Guzzino J, Khalili W, Tekin A, Bansal V, Kashyap R, Joyce WJ, Lewis PA, Sanghavi D, Gavrancic T, and Moreno Franco P
- Subjects
- Adult, Humans, Male, Female, SARS-CoV-2, Incidence, Retrospective Studies, Adrenal Cortex Hormones, COVID-19 complications, COVID-19 epidemiology, Mediastinal Emphysema epidemiology, Mediastinal Emphysema etiology, Mediastinal Emphysema therapy, Pneumothorax epidemiology, Pneumothorax etiology, Pneumothorax therapy, Subcutaneous Emphysema etiology, Subcutaneous Emphysema complications
- Abstract
Background: Limited data is available on the incidence and outcomes of pneumothorax (PTX), pneumomediastinum (PNM), and subcutaneous emphysema (SCE) in COVID-19 patients. This study aimed to investigate the characteristics of these complications in hospitalized COVID-19 patients., Research Design and Methods: A retrospective study was conducted, involving adult COVID-19 patients admitted to Mayo Clinic Florida from 03/2020-06/2022. Patients were divided into two groups based on the presence or absence of PTX/PNM/SCE., Results: 1926 hospitalized patients with COVID-19 were included, of which 518 were admitted to the ICU. The incidence of PTX/PNM/SCE was 6.3%. Patients with these complications were more likely to be male, Asian, and unvaccinated. Conversely, they were less likely to have chronic obstructive pulmonary disease. Patients who developed PTX/PNM/SCE after 72 hours of admission were more likely to receive high-dose corticosteroids and for an extended duration. The affected group had an adjusted odds ratio for in-hospital mortality of 13.32 (95%CI, 8.19-21.59) and ICU admission of 9.14 (95%CI, 5.3-12.78) compared to the unaffected group., Conclusion: Although the occurrence of PTX/PNM/SCE in hospitalized COVID-19 patients was rare, it was associated with worse outcomes. Corticosteroids may contribute to the pathogenesis of these complications; however, further studies are needed to investigate this relationship in more detail.
- Published
- 2023
- Full Text
- View/download PDF