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新型冠状病毒肺炎相关性气胸:病例系列

Pneumothorax In Covid-19 Pneumonia: A case series.

作者信息

Hameed Mansoor, Jamal Wasim, Yousaf Muhammad, Thomas Merlin, Haq Irfan Ul, Ahmed Shakeel, Ahmad Mushtaq, Khatib Mohamad

机构信息

Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

Weill Cornell Medicine-Qatar, Cornell University, Qatar.

出版信息

Respir Med Case Rep. 2020;31:101265. doi: 10.1016/j.rmcr.2020.101265. Epub 2020 Oct 21.

Abstract

BACKGROUND

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.

DISCUSSION

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.

CONCLUSION

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.

摘要

背景

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。

讨论

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ed2/7596343/0a9c30ea2542/gr1a.jpg

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