COVID-19 and pneumothorax: a multicentre retrospective case series
COVID-19 and pneumothorax: a multicentre retrospective case series
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DOI：
10.1183/13993003.02697-2020
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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：
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作者：
Martinelli, Anthony W.;Ingle, Tejas;Marciniak, Stefan J.
简介：气胸和纵隔气肿都会使 2019 年冠状病毒病 (COVID-19) 病例变得复杂，需要住院治疗。我们报告了迄今为止最大的病例系列，涉及患有这两种疾病的患者（包括非通气患者）。方法：从英国医院回顾性收集病例，纳入标准仅限于诊断为 COVID-19 且存在气胸或纵隔气肿。该研究纳入的患者于 2020 年 3 月至 6 月期间进行。从病历中获得的详细信息包括人口统计、放射学、实验室检查、临床管理和生存情况。结果：该研究纳入了来自 16 个中心的 71 名患者，其中 60 例患有气胸（另外 6 例伴有纵隔气肿），11 例仅患有纵隔气肿。其中两名患者有两次不同的气胸发作，连续发生在双侧，使气胸总数达到 62 例。临床情况包括因气胸入院的患者、因 COVID-19 住院期间出现气胸或纵隔气肿的患者，以及在插管和通气时出现并发症的患者，无论是否同时进行体外膜肺氧合。气胸 (63.1 +/- 6.5%) 或孤立性纵隔气肿 (53.0 +/- 18.7%；p=0.854) 后 28 天的生存率没有显着差异。男性气胸的发生率较高。两性之间的 28 天生存率没有差异（男性为 62.5 +/- 7.7%，女性为 68.4 +/- 10.7%；p=0.619）。年龄 >= 70 岁的患者的 28 天生存率显着低于年轻患者（>= 70 岁的患者的生存率为 41.7 +/- 13.5%
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