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气胸作为新冠病毒病的晚期并发症

Pneumothorax as a late complication of COVID-19.

作者信息

Ferreira João Guimarães, Rapparini Cristiane, Gomes Bruno Moreno, Pinto Luiz Alexandre Cabral, Freire Mário Sérgio da Silva E

机构信息

Hospital Unimed Resende, Resende, Rio de Janeiro, Brazil.

Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2020;62:e61. doi: 10.1590/s1678-9946202062061. Epub 2020 Aug 31.

Abstract

In late 2019, a novel coronavirus initially related to a cluster of severe pneumonia cases in China was identified. COVID-19 cases have rapidly spread to multiple countries worldwide. We present a typical laboratory confirmed case of COVID-19 pneumonia, that was hospitalized due to hypoxemia but did not require mechanical ventilation. Although initially the patient was evaluated with a favorable outcome, in the third week of the disease, the symptomatology deteriorated due to a massive hypertensive pneumothorax with no known previous risk factor. Since the first cases of COVID-19 have been described, pneumothorax was characterized as a potential, though uncommon, complication. It has been reported that diffuse alveolar injury caused by SARS-CoV-2 can cause alveolar rupture, produce air leakage and interstitial emphysema. Although uncommon, pneumothorax should be listed as a differential diagnosis for COVID-19 patients with sudden respiratory decompensation. As a life-threatening event, it requires prompt recognition and expeditious treatment.

摘要

2019年末,一种最初与中国一组重症肺炎病例相关的新型冠状病毒被发现。新型冠状病毒肺炎(COVID-19)病例已迅速蔓延至全球多个国家。我们报告一例典型的实验室确诊的COVID-19肺炎病例,该患者因低氧血症住院,但无需机械通气。尽管最初对患者的评估结果良好,但在疾病的第三周,由于出现大量高血压性气胸且无已知既往危险因素,症状恶化。自首次描述COVID-19病例以来,气胸被认为是一种潜在的、虽不常见但会出现的并发症。据报道,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的弥漫性肺泡损伤可导致肺泡破裂、产生漏气和间质性肺气肿。尽管不常见,但气胸应列为COVID-19患者突然呼吸失代偿的鉴别诊断之一。作为一种危及生命的事件,它需要及时识别和迅速治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ef1/7458073/57f0a739df33/1678-9946-rimtsp-62-S1678-9946202062061-gf01.jpg

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