Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Thorac Cardiovasc Surg. 2021 Aug;69(5):470-474. doi: 10.1055/s-0040-1721061. Epub 2020 Dec 1.
At present, the coronavirus disease 2019 (COVID-19) is spreading all over the world. The occurrence of spontaneous pneumothorax in these patients might be higher than the fact, and we should pay high clinical attention to them.
Data regarding clinical investigation, laboratory investigation, diagnosis, and treatment measures of 21 COVID-19 patients with spontaneous pneumothorax from January to March of 2020 were collected and analyzed in this study.
Seven patients had a history of basic lung diseases. All patients used different methods of oxygen therapy before the occurrence of spontaneous pneumothorax according to the severity of the COVID-19, including 18 patients with ventilator-assisted breathing, 2 patients with bilevel positive airway pressure assisted breathing, and 1 patient with mask oxygen inhalation. All patients were confirmed cases of COVID-19 by chest CT (computed tomography) and virus nucleic acid detection and were found to have spontaneous pneumothorax through physical examination, bedside X-ray, and/or bedside ultrasound. 13 of 21 patients combined with pleural effusion at the same time. All the patients underwent closed thoracic drainage for spontaneous pneumothorax and the pleural effusion, if any. Nine patients died, and 12 patients recovered smoothly.
Spontaneous pneumothorax might be an overlooked complication of COVID-19 patients and may be associated with poor prognosis.
目前,新型冠状病毒肺炎(COVID-19)正在全球范围内传播。这些患者自发性气胸的发生率可能高于实际情况,我们应高度重视。
本研究收集并分析了 2020 年 1 月至 3 月期间 21 例 COVID-19 合并自发性气胸患者的临床调查、实验室检查、诊断和治疗措施的数据。
7 例患者有基础肺部疾病史。所有患者在自发性气胸发生前根据 COVID-19 的严重程度采用不同的氧疗方法,包括 18 例呼吸机辅助呼吸、2 例双水平气道正压辅助呼吸和 1 例面罩吸氧。所有患者均通过胸部 CT(计算机断层扫描)和病毒核酸检测确诊为 COVID-19,并通过体格检查、床边 X 线和/或床边超声发现自发性气胸。21 例患者中有 13 例同时合并胸腔积液。所有患者均行自发性气胸及胸腔积液的胸腔闭式引流。9 例患者死亡,12 例患者顺利康复。
自发性气胸可能是 COVID-19 患者被忽视的并发症,可能与不良预后相关。