Pneumothorax, pneumomediastinum, and subcutaneous emphysema in hospitalized COVID-19 patients: incidence, clinical characteristics, and outcomes.

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-07-01 Epub Date: 2023-09-11 DOI:10.1080/17476348.2023.2254689
Aleksandra Murawska Baptista, Jorge Sinclair De Frías, Trisha Singh, Ananya Vasudhar, Jacob Guzzino, Waheed Khalili, Aysun Tekin, Vikas Bansal, Rahul Kashyap, William J Joyce, Patricia A Lewis, Devang Sanghavi, Tatjana Gavrancic, Pablo Moreno Franco
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Abstract

Background: Limited data is available on the incidence and outcomes of pneumothorax (PTX), pneumomediastinum (PNM), and subcutaneous emphysema (SCE) in COVID-19 patients. This study aimed to investigate the characteristics of these complications in hospitalized COVID-19 patients.

Research design and methods: A retrospective study was conducted, involving adult COVID-19 patients admitted to Mayo Clinic Florida from 03/2020-06/2022. Patients were divided into two groups based on the presence or absence of PTX/PNM/SCE.

Results: 1926 hospitalized patients with COVID-19 were included, of which 518 were admitted to the ICU. The incidence of PTX/PNM/SCE was 6.3%. Patients with these complications were more likely to be male, Asian, and unvaccinated. Conversely, they were less likely to have chronic obstructive pulmonary disease. Patients who developed PTX/PNM/SCE after 72 hours of admission were more likely to receive high-dose corticosteroids and for an extended duration. The affected group had an adjusted odds ratio for in-hospital mortality of 13.32 (95%CI, 8.19-21.59) and ICU admission of 9.14 (95%CI, 5.3-12.78) compared to the unaffected group.

Conclusion: Although the occurrence of PTX/PNM/SCE in hospitalized COVID-19 patients was rare, it was associated with worse outcomes. Corticosteroids may contribute to the pathogenesis of these complications; however, further studies are needed to investigate this relationship in more detail.

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新冠肺炎住院患者的胸腔、纵隔气肿和皮下气肿:发病率、临床特征和结果。
背景:关于新冠肺炎患者中的肺气肿(PTX)、纵隔气肿(PNM)和皮下气肿(SCE)的发病率和结果的数据有限。本研究旨在调查新冠肺炎住院患者的这些并发症的特征。研究设计和方法:进行了一项回顾性研究,涉及2020-06/2022年3月入住佛罗里达州梅奥诊所的成年新冠肺炎患者。根据PTX/PNM/SCE的存在与否,将患者分为两组。结果:纳入1926名新冠肺炎住院患者,其中518人入住ICU。PTX/PNM/SCE的发生率为6.3%。有这些并发症的患者更有可能是男性、亚洲人和未接种疫苗的人。相反,他们患慢性阻塞性肺病的可能性较小。72岁后出现PTX/PNM/SCE的患者 入院数小时更有可能接受高剂量皮质类固醇治疗并延长治疗时间。与未受影响组相比,受影响组的住院死亡率调整比值比为13.32(95%可信区间,8.19-21.59),ICU入院率为9.14(95%置信区间,5.3-12.78)。结论:尽管新冠肺炎住院患者PTX/PNM/SCE的发生率较低,但其与更严重的预后有关。皮质类固醇可能参与这些并发症的发病机制;然而,还需要进一步的研究来更详细地研究这种关系。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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