Murawska Baptista Aleksandra, Sinclair De Frías Jorge, Singh Trisha, Vasudhar Ananya, Guzzino Jacob, Khalili Waheed, Tekin Aysun, Bansal Vikas, Kashyap Rahul, Joyce William J, Lewis Patricia A, Sanghavi Devang, Gavrancic Tatjana, Moreno Franco Pablo
Department of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.
Expert Rev Respir Med. 2023 Jul-Dec;17(8):727-733. doi: 10.1080/17476348.2023.2254689. Epub 2023 Sep 11.
Limited data is available on the incidence and outcomes of pneumothorax (PTX), pneumomediastinum (PNM), and subcutaneous emphysema (SCE) in COVID-19 patients. This study aimed to investigate the characteristics of these complications in hospitalized COVID-19 patients.
A retrospective study was conducted, involving adult COVID-19 patients admitted to Mayo Clinic Florida from 03/2020-06/2022. Patients were divided into two groups based on the presence or absence of PTX/PNM/SCE.
1926 hospitalized patients with COVID-19 were included, of which 518 were admitted to the ICU. The incidence of PTX/PNM/SCE was 6.3%. Patients with these complications were more likely to be male, Asian, and unvaccinated. Conversely, they were less likely to have chronic obstructive pulmonary disease. Patients who developed PTX/PNM/SCE after 72 hours of admission were more likely to receive high-dose corticosteroids and for an extended duration. The affected group had an adjusted odds ratio for in-hospital mortality of 13.32 (95%CI, 8.19-21.59) and ICU admission of 9.14 (95%CI, 5.3-12.78) compared to the unaffected group.
Although the occurrence of PTX/PNM/SCE in hospitalized COVID-19 patients was rare, it was associated with worse outcomes. Corticosteroids may contribute to the pathogenesis of these complications; however, further studies are needed to investigate this relationship in more detail.
关于新冠病毒疾病（COVID-19）患者气胸（PTX）、纵隔气肿（PNM）和皮下气肿（SCE）的发病率及预后的数据有限。本研究旨在调查住院COVID-19患者这些并发症的特征。
进行了一项回顾性研究，纳入了2020年3月至2022年6月在佛罗里达州梅奥诊所住院的成年COVID-19患者。根据是否存在PTX/PNM/SCE将患者分为两组。
纳入了1926例住院COVID-19患者，其中518例入住重症监护病房（ICU）。PTX/PNM/SCE的发生率为6.3%。有这些并发症的患者更可能为男性、亚洲人且未接种疫苗。相反，他们患慢性阻塞性肺疾病的可能性较小。入院72小时后发生PTX/PNM/SCE的患者更可能接受高剂量皮质类固醇治疗且疗程更长。与未受影响的组相比，受影响组院内死亡的调整优势比为13.32（95%置信区间，8.19 - 21.59），入住ICU的调整优势比为9.14（95%置信区间，5.3 - 12.78）。
尽管住院COVID-19患者中PTX/PNM/SCE的发生罕见，但它与更差的预后相关。皮质类固醇可能促成这些并发症的发病机制；然而，需要进一步研究更详细地调查这种关系。
