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新型冠状病毒肺炎并发气胸:发病率及临床特征。

Pneumothorax in COVID-19 disease- incidence and clinical characteristics.

机构信息

Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA.

出版信息

Respir Res. 2020 Sep 16;21(1):236. doi: 10.1186/s12931-020-01504-y.

Abstract

BACKGROUND

Spontaneous pneumothorax is an uncommon complication of COVID-19 viral pneumonia. The exact incidence and risk factors are still unknown. Herein we review the incidence and outcomes of pneumothorax in over 3000 patients admitted to our institution for suspected COVID-19 pneumonia.

METHODS

We performed a retrospective review of COVID-19 cases admitted to our hospital. Patients who were diagnosed with a spontaneous pneumothorax were identified to calculate the incidence of this event. Their clinical characteristics were thoroughly documented. Data regarding their clinical outcomes were gathered. Each case was presented as a brief synopsis.

RESULTS

Three thousand three hundred sixty-eight patients were admitted to our institution between March 1st, 2020 and June 8th, 2020 for suspected COVID 19 pneumonia, 902 patients were nasopharyngeal swab positive. Six cases of COVID-19 patients who developed spontaneous pneumothorax were identified (0.66%). Their baseline imaging showed diffuse bilateral ground-glass opacities and consolidations, mostly in the posterior and peripheral lung regions. 4/6 cases were associated with mechanical ventilation. All patients required placement of a chest tube. In all cases, mortality (66.6%) was not directly related to the pneumothorax.

CONCLUSION

Spontaneous pneumothorax is a rare complication of COVID-19 viral pneumonia and may occur in the absence of mechanical ventilation. Clinicians should be vigilant about the diagnosis and treatment of this complication.

摘要

背景

自发性气胸是 COVID-19 病毒性肺炎的一种罕见并发症。确切的发病率和危险因素仍不清楚。在此,我们回顾了在我院收治的 3000 多名疑似 COVID-19 肺炎患者中气胸的发病率和结局。

方法

我们对我院收治的 COVID-19 病例进行了回顾性研究。确诊自发性气胸的患者被确定,以计算该事件的发病率。详细记录了他们的临床特征。收集了他们临床结局的数据。每个病例都以简要摘要的形式呈现。

结果

2020 年 3 月 1 日至 6 月 8 日期间,我院收治了 3368 名疑似 COVID-19 肺炎的患者,902 名患者鼻咽拭子检测呈阳性。发现 6 例 COVID-19 患者并发自发性气胸(0.66%)。他们的基线影像学表现为弥漫性双侧磨玻璃影和实变影,主要位于肺后部和外周。4/6 例与机械通气有关。所有患者均需放置胸腔引流管。所有患者的死亡率(66.6%)与气胸无关。

结论

自发性气胸是 COVID-19 病毒性肺炎的一种罕见并发症,即使在没有机械通气的情况下也可能发生。临床医生应警惕该并发症的诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2335/7493325/c82a23b3e42f/12931_2020_1504_Fig1_HTML.jpg

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