Hameed Mansoor, Jamal Wasim, Yousaf Muhammad, Thomas Merlin, Haq Irfan Ul, Ahmed Shakeel, Ahmad Mushtaq, Khatib Mohamad
Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Weill Cornell Medicine-Qatar, Cornell University, Qatar.
Respir Med Case Rep. 2020;31:101265. doi: 10.1016/j.rmcr.2020.101265. Epub 2020 Oct 21.
Coronavirus disease 2019 (Covid-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It mainly affects the lungs and common symptoms are fever, cough and shortness of breath. Pneumothorax has been noted to complicate Covid-19 cases requiring hospital admission, however the exact incidence and risk factors are still unknown.
We present a series of 3 cases of primary spontaneous pneumothorax with Covid-19 pneumonia. All cases in our series did not require positive pressure ventilation and none had any pre-existing lung disease. All were never smokers and had favourable outcomes despite having severe Covid-19 with a pneumothorax during the course of the disease. In our literature review we discuss several plausible mechanisms and risk factors resulting in a pneumothorax with Covid-19.
Our cases are a reminder that an acute deterioration with hypoxia in a Covid-19 patient could indicate a pneumothorax. Pneumothorax is one of the reported complications in Covid-19 and clinician vigilance is required during assessment of patients, as both share the common symptom of breathlessness and therefore can mimic each other.
2019冠状病毒病（Covid-19）是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的一种传染病。它主要影响肺部，常见症状为发热、咳嗽和呼吸急促。气胸已被发现是需要住院治疗的Covid-19病例的并发症，然而其确切发病率和危险因素仍不清楚。
我们报告了3例合并Covid-19肺炎的原发性自发性气胸病例。我们系列中的所有病例均不需要正压通气，且均无既往肺部疾病。所有患者均从不吸烟，尽管在疾病过程中患有严重的Covid-19并伴有气胸，但预后良好。在我们的文献综述中，我们讨论了导致Covid-19合并气胸的几种可能机制和危险因素。
我们的病例提醒人们，Covid-19患者出现缺氧导致的急性病情恶化可能提示气胸。气胸是Covid-19报告的并发症之一，在评估患者时临床医生需要保持警惕，因为两者都有呼吸急促这一共同症状，因此可能相互模仿。
