Pneumothorax in patients with COVID-19 pneumonia in the intensive care unit: an indicator of poor prognosis

Authors : Onur Küçük, Fatih Seğmen, Semih Aydemir

Pages : 13-19

Doi:10.47582/jompac.1604018

View : 55 | Download : 51

Publication Date : 2025-02-14

Article Type : Research Paper

Abstract :Aims: The objective of this study was to investigate whether the incidence and development of pneumothorax in patients hospitalized in the intensive care unit (ICU) with coronavirus disease 2019 (COVID-19) pneumonia is associated with patient prognosis. Methods: This retrospective, cohort, descriptive study was initiated following approval from the ethics committee. The study was conducted on patients with confirmed COVID-19 pneumonia admitted to the tertiary ICU between March 2020 and March 2022. Data were collected from the patient registry system and ICU files. The patients were divided into two groups: those who developed pneumothorax and those who did not. The factors associated with mortality in the ICU were evaluated by univariate analysis and multiple logistic regression analysis. Results: The study included a total of 397 patients with confirmed cases of COVID-19 infection and pneumonia who were admitted to the ICU between March 2020 and March 2022. The mean age of the patients was 62±15 years. Of the patients, 56.1% were male. Pneumothorax was identified in 6.8% of patients. In addition to pneumothorax, six patients (1.5%) exhibited pneumomediastinum. The mortality rate was observed to be 40.5% among the total patient population. The mortality rate was 81.5% in the group with pneumothorax and 37.6% in the group without pneumothorax. The median time to mortality was 6 days (range 1–29 days) following the diagnosis of pneumothorax. Pneumothorax alone increased the likelihood of mortality in the ICU sevenfold (OR 7.3, 95% CI=2.70–19.75) and twofold when other variables were taken into account (OR 2, 95% CI=0.57-6.99). Conclusion: Pneumothorax is a common and fatal complication affecting mortality in patients with COVID-19 pneumonia in the ICU, despite the use of protective ventilation strategies. Particular caution should be exercised in patients receiving respiratory support in the ICU and in patients with a severe inflammatory response.
Keywords : pnömotoraks, pnömomediastinum, yoğun bakım ünitesi, prognoz, COVID-19

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