Cabrera Gaytán David Alejandro, Pérez Andrade Yadira, Espíritu Valenzo Yuridia
Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Av. Cuauhtémoc # 330 Block "B" 4° Floor, Annex to the Unidad de Congresos del Centro Médico Nacional Siglo XXI, Neighborhood Doctores, Alcaldía Cuauhtmoc, CP. 06720, Mexico City, Mexico.
Coordinación de Vigilancia Epidemiológica, Instituto Mexicano del Seguro Social, Mier y Pesado No. 120, Neighborhood Del Valle Benito Juárez, CP. 03100, Mexico City, Mexico.
Respir Med Case Rep. 2021;34:101490. doi: 10.1016/j.rmcr.2021.101490. Epub 2021 Jul 26.
Cases of pneumothorax/pneumomediastinum have been reported in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, the time to onset and hospital stay have rarely been studied. Coronavirus disease 2019 (COVID-19) patients with these complications are described to determine the time to onset, associated comorbidities, and location and duration of pneumothorax. A search in PubMed yielded simple frequencies and a bivariate analysis of deaths. There were 113 confirmed cases in 67 articles. The median time from the date of hospital admission to the presence of pneumothorax was 8 days. Right hemithorax was the most frequent form of pneumothorax. Almost half of the patients required intubation for invasive mechanical ventilation. Although the frequency of this phenomenon was not high among hospitalized patients with confirmed SARS-CoV-2, it was high among those who developed acute respiratory distress syndrome (ARDS). This study contributes to the literature because it presents a large number of patients who developed pneumothorax after admission, which was characterized by clinical deterioration (dyspnea, tachypnea, pleuritic chest pain, and subcutaneous emphysema) and low oxygen saturation levels. Pneumothorax/pneumomediastinum is recommended as a differential diagnosis, even without considering the presence of chronic pulmonary comorbidities or invasive mechanical ventilation.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者中已报告气胸/纵隔气肿病例；然而，发病时间和住院时间很少被研究。描述2019冠状病毒病（COVID-19）合并这些并发症的患者，以确定发病时间、相关合并症以及气胸的部位和持续时间。在PubMed上进行检索，得出简单频率和死亡的双变量分析结果。67篇文章中有113例确诊病例。从入院日期到出现气胸的中位时间为8天。右侧胸腔是最常见的气胸类型。几乎一半的患者需要插管进行有创机械通气。尽管这种现象在确诊SARS-CoV-2的住院患者中发生率不高，但在发生急性呼吸窘迫综合征（ARDS）的患者中发生率较高。这项研究为文献做出了贡献，因为它呈现了大量入院后发生气胸的患者，其特征为临床恶化（呼吸困难、呼吸急促、胸膜炎性胸痛和皮下气肿）以及低氧饱和度水平。即使不考虑慢性肺部合并症或有创机械通气的存在，气胸/纵隔气肿也被推荐作为鉴别诊断。
