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. 2022 Jan 11:15:489-500.
doi: 10.2147/IJGM.S347178. eCollection 2022.

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

Adina Maria Marza  1   2 , Alina Petrica  1   3 , Diana Lungeanu  4 , Dumitru Sutoi  1   5 , Alexandra Mocanu  6 , Ioan Petrache  1   7 , Ovidiu Alexandru Mederle  1   2
Affiliations

Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection

Adina Maria Marza et al. Int J Gen Med. .

Abstract

Background and objectives: Spontaneous pneumothorax (SP) and spontaneous pneumomediastinum (SPM) have frequently been cited as complications associated with coronavirus disease 2019 (COVID-19) pneumonia, with especially poor prognosis in mechanically ventilated patients. The current literature is controversial regarding the potential risk factors for developing SP or SPM (SP-SPM) in non-ventilated COVID-19 patients. Our research addressed a twofold objective: (a) to investigate the characteristics of patients with SP-SPM (both with and without COVID-19) and compare them to patients with sole COVID-19; (b) to quantify the risk of in-hospital mortality associated with SP-SPM and COVID-19.

Patients and methods: A retrospective case-control study was conducted in the emergency departments (ED) of two tertiary hospitals in Timisoara, Romania, over one year (1st April 2020‒31st March 2021; 64,845 records in total) and 70 cases of SP-SPM were identified (both SARS-CoV-2 positives and negatives). The control group comprised COVID-19 patients with no SP-SPM, included at a 2:1 ratio. Logistic regression was employed to quantify the in-hospital mortality risk associated with age, SP-SPM, and COVID-19.

Results: SP-SPM and COVID-19 were connected with prolonged hospitalization, a higher percentage of intensive care admission, and a higher mortality. SP-SPM increased the odds of death by almost four times in patients of the same age, gender, smoking status, and SARS-CoV-2 infection: OR = 3.758, 95% CI (1.443-9.792). Each additional year of age added 9.4% to the mortality risk: OR = 1.094, 95% CI (1.054-1.135).

Conclusion: ED physicians should acknowledge these potential risks when attending COVID-19 patients with SP-SPM.

Keywords: COVID-19; case–control study; chest CT; chest pain; dyspnea; in-hospital mortality.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flow diagram.
See this image and copyright information in PMC

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