Abstract

Objective:

Pneumothorax (PNX) and subcutaneous emphysema (SCE) have increased in importance as a frequently occurring complication. This study aimed to reveal the frequency, timing, and possible risk factors in patients with PNX and SCE who are followed up with coronavirus disease-2019 (COVID-19) diagnosis in our tertiary intensive care unit (ICU).

Materials and Methods:

All patients with confirmed COVID-19 who were followed up and treated in our unit between August 8, 2020, and February 20, 2021, in a 16-bed tertiary ICU and who developed PNX and SCE during their hospitalization were included.

Results:

PNX and SCE developed in 16 (9.6%) of 165 patients who were followed up in our ICU due to COVID-19. Of these 16 patients, 3 (18.8%) survived. The median age of patients was 66.5 years (interquartile range: 58.5-75.5). Diabetes mellitus was the most common comorbidity in patients with PNX and SCE. Additionally, 12 (75%) patients had a smoking history. Of 15 (93.8%) patients who developed PNX, 4 (25%) were bilateral, and SCE developed in 9 (56.3%) patients. Twelve (75%) patients with PNX and SCE were under invasive mechanical ventilation, 3 (18.8%) under spontaneous breathing, and 1 (6.2%) under non-invasive mechanical ventilation treatment. The number of oxygen support days until the time PNX and SCE developed was 9 (6.25-17) days in the whole group, the median time was 6 days in the survival group and 9 days in the non-survival group.

Conclusion:

In the COVID-19 pandemic, complications, such as PNX and SCE, are more frequently observed (9.5%) than in the general intensive care population and the later period of intensive care admission (median 9 days). Smoking is defined as a risk factor in most of these patients; however, increased PNX rates are thought to be related to both COVID-19 pneumonia and parenchymal damage due to cytokine storms.

Keywords: COVID-19, pneumothorax, intensive care unit

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Copyright and license

Copyright © 2021 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite?

1.
Pehlivanlar Küçük M, Öksüz Güngör B, Küçük AO, Ayçiçek O, Türkyılmaz A, Öztuna F, et al. Pneumothorax and Subcutaneous Emphysema Evaluation in Patients with COVID-19 in the Intensive Care Unit. Turk J Intensive Care. 2021;19:95-101. https://doi.org/10.4274/tybd.galenos.2021.30316