Management of spontaneous pneumothorax in patients with COVID-19.

Ulutas, H; Celik, MR; Gulcek, I; Kalkan, M; Agar, M; Kilic, T; Gulcek, E

Management of spontaneous pneumothorax in patients with COVID-19.

Ulutas, H Celik, MR Gulcek, I Kalkan, M Agar, M

Kilic, T Gulcek, E

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Publisher:: Oxford University Press (OUP)
Publication Type:: Journal Article
Citation:: Interactive cardiovascular and thoracic surgery, 2021, pp. ivab280-
Issue Date:: 2021-10-18

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Field	Value	Language
dc.contributor.author	Ulutas, H
dc.contributor.author	Celik, MR
dc.contributor.author	Gulcek, I
dc.contributor.author	Kalkan, M
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119
dc.contributor.author	Kilic, T
dc.contributor.author	Gulcek, E
dc.date.accessioned	2022-01-04T03:58:13Z
dc.date.available	2021-09-10
dc.date.available	2022-01-04T03:58:13Z
dc.date.issued	2021-10-18
dc.identifier.citation	Interactive cardiovascular and thoracic surgery, 2021, pp. ivab280-
dc.identifier.issn	1569-9293
dc.identifier.issn	1569-9285
dc.identifier.uri	http://hdl.handle.net/10453/152654
dc.description.abstract	<h4>Objectives</h4>The coronavirus disease 2019 (COVID-19) pneumonia may cause cystic features of lung parenchyma which can resolve or progress to larger blebs. Pneumothorax was more likely in patients with neutrophilia, severe lung injury and a prolonged clinical course. The timely diagnosis and management will reduce COVID-19-associated morbidity and mortality.<h4>Methods</h4>We present 11 cases of spontaneous pneumothorax managed with chest tube thoracostomy or high-dose oxygen therapy. Isolated spontaneous pneumothorax was detected in all cases.<h4>Results</h4>Eight cases were male and 3 cases were female. There were bilateral ground-glass opacities or pulmonary infiltrates in the parenchyma of the 10 cases. We detected neutrophilia, lymphopaenia and increased C-reactive protein, Ferritin, lactate dehydrogenase, D-Dimer, interleukin-6 levels in almost all cases. Chest tube thoracostomy was sufficient to treat pneumothorax in our 9 of case. In 2 cases, pneumothorax healed with high-dose oxygen therapy. Favipiravir and antibiotic treatment were given to different 10 patients. In our institution, all patients with COVID-19 infection were placed on prophylactic or therapeutic anticoagulation, unless contraindicated. The treatments of patients diagnosed with secondary spontaneous pneumothorax during the pandemic period and those diagnosed with secondary spontaneous pneumothorax in the previous 3 years were compared with the durations of tube thoracostomy performed in both groups.<h4>Conclusions</h4>The increased number of cases of pneumothorax suggests that pneumothorax may be a complication of COVID-19 infection. During medical treatment of COVID-19, pneumothorax may be the only reason for hospitalization. Although tube thoracostomy is a sufficient treatment option in most cases, clinicians should be aware of the difficulties that may arise in diagnosis and treatment.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Oxford University Press (OUP)
dc.relation.ispartof	Interactive cardiovascular and thoracic surgery
dc.relation.isbasedon	10.1093/icvts/ivab280
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1004 Medical Biotechnology, 1103 Clinical Sciences
dc.subject.classification	Respiratory System
dc.title	Management of spontaneous pneumothorax in patients with COVID-19.
dc.type	Journal Article
utslib.location.activity	England
utslib.for	1004 Medical Biotechnology
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2022-01-04T03:58:12Z
pubs.publication-status	Published

Abstract:

Objectives

The coronavirus disease 2019 (COVID-19) pneumonia may cause cystic features of lung parenchyma which can resolve or progress to larger blebs. Pneumothorax was more likely in patients with neutrophilia, severe lung injury and a prolonged clinical course. The timely diagnosis and management will reduce COVID-19-associated morbidity and mortality.

Methods

We present 11 cases of spontaneous pneumothorax managed with chest tube thoracostomy or high-dose oxygen therapy. Isolated spontaneous pneumothorax was detected in all cases.

Results

Eight cases were male and 3 cases were female. There were bilateral ground-glass opacities or pulmonary infiltrates in the parenchyma of the 10 cases. We detected neutrophilia, lymphopaenia and increased C-reactive protein, Ferritin, lactate dehydrogenase, D-Dimer, interleukin-6 levels in almost all cases. Chest tube thoracostomy was sufficient to treat pneumothorax in our 9 of case. In 2 cases, pneumothorax healed with high-dose oxygen therapy. Favipiravir and antibiotic treatment were given to different 10 patients. In our institution, all patients with COVID-19 infection were placed on prophylactic or therapeutic anticoagulation, unless contraindicated. The treatments of patients diagnosed with secondary spontaneous pneumothorax during the pandemic period and those diagnosed with secondary spontaneous pneumothorax in the previous 3 years were compared with the durations of tube thoracostomy performed in both groups.

Conclusions

The increased number of cases of pneumothorax suggests that pneumothorax may be a complication of COVID-19 infection. During medical treatment of COVID-19, pneumothorax may be the only reason for hospitalization. Although tube thoracostomy is a sufficient treatment option in most cases, clinicians should be aware of the difficulties that may arise in diagnosis and treatment.

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http://hdl.handle.net/10453/152654