COVID-19 and pneumothorax: a multicentre retrospective case series
COVID-19 and pneumothorax: a multicentre retrospective case series
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DOI：
10.1183/13993003.02967-2020
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发表时间：
2020-11-01
影响因子：
24.3
通讯作者：
Marciniak, Stefan J.
中科院分区：
文献类型：
--
作者：
Martinelli, Anthony W.;Ingle, Tejas;Marciniak, Stefan J.
简介：气胸和肺气肿都被认为是2019冠状病毒病（COVID-19）需要住院的复杂病例。我们报告了迄今为止描述的最大的病例系列，这些患者同时患有这两种病理（包括非通气患者）。方法：病例回顾性收集自英国医院，纳入标准仅限于COVID-19的诊断和气胸或肺气肿的存在。纳入研究的患者于2020年3月至6月期间提交。从病历中获得的详细信息包括人口统计学，放射学，实验室检查，临床管理和survival.Results：71例患者从16个中心被列入研究，其中60例气胸（6个pneumomegalinum）和11个pneumomegalinum单独。其中两名患者有两次不同的气胸发作，以连续的方式发生在双侧，使气胸的总数达到62例。临床情况包括因气胸入院的患者、因COVID-19住院期间发生气胸或肺气肿的患者以及在插管和通气时发生并发症的患者，无论是否同时进行体外膜肺氧合。气胸（63.1 ± 6.5%）或孤立性肺气肿（53.0 ± 18.7%; p=0.854）后28天的生存率无显著差异。男性气胸发生率较高。28-两种性别之间的日存活率无差异（男性62.5 +/- 7.7% vs女性68.4 +/- 10.7%; p=0.619）。年龄>= 70岁的患者28天生存率显著低于年轻患者（>= 70岁41.7 +/- 13.5%生存率，
Introduction: Pneumothorax and pneumomediastinum have both been noted to complicate cases of coronavirus disease 2019 (COVID-19) requiring hospital admission. We report the largest case series yet described of patients with both these pathologies (including nonventilated patients).Methods: Cases were collected retrospectively from UK hospitals with inclusion criteria limited to a diagnosis of COVID-19 and the presence of either pneumothorax or pneumomediastinum. Patients included in the study presented between March and June 2020. Details obtained from the medical record included demographics, radiology, laboratory investigations, clinical management and survival.Results: 71 patients from 16 centres were included in the study, of whom 60 had pneumothoraces (six with pneumomediastinum in addition) and 11 had pneumomediastinum alone. Two of these patients had two distinct episodes of pneumothorax, occurring bilaterally in sequential fashion, bringing the total number of pneumothoraces included to 62. Clinical scenarios included patients who had presented to hospital with pneumothorax, patients who had developed pneumothorax or pneumomediastinum during their inpatient admission with COVID-19 and patients who developed their complication while intubated and ventilated, either with or without concurrent extracorporeal membrane oxygenation. Survival at 28 days was not significantly different following pneumothorax (63.1 +/- 6.5%) or isolated pneumomediastinum (53.0 +/- 18.7%; p=0.854). The incidence of pneumothorax was higher in males. 28-day survival was not different between the sexes (males 62.5 +/- 7.7% versus females 68.4 +/- 10.7%; p=0.619). Patients aged >= 70 years had a significantly lower 28-day survival than younger individuals (>= 70 years 41.7 +/- 13.5% survival versus