Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy
Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients’ outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. Methods: A retrospective multicente...
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2021
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oai:doaj.org-article:ef777375d5864793842e51955b7a62532021-11-11T17:30:07ZPneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy10.3390/jcm102148352077-0383https://doaj.org/article/ef777375d5864793842e51955b7a62532021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4835https://doaj.org/toc/2077-0383Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients’ outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. Methods: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX/PNM were compared. Results: Among 1213 patients, PNX and/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX/PNM showed higher in-hospital (<i>p</i> = 0.02) and 90-days mortality (<i>p</i> = 0.048), and longer hospitalization length (<i>p</i> = 0.002) than COVID-19 patients without PNX/PNM. At PNX/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX/PNM occurrence was associated with longer symptom length before hospital admission (<i>p</i> = 0.005) and lower levels of blood lymphocytes (<i>p</i> = 0.017). Conclusion: PNX/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation.Matteo BonatoAlessia FraccaroNicholas LandiniGiuseppe ZanardiCosimo CatinoFrancesca SavoiaNicola MalacchiniFabiola ZerajPiera PedittoVito CatalanottiElisabetta MarconEmanuela RossiAlessia PaulettiSilvia GalvanRiccardo AdamiMarta TiepoloMauro SalasnichMaria CuzzolaFrancesca ZampieriMarcello RattazziMario PetaSimonetta BaraldoMarina SaettaGiovanni MoranaMicaela RomagnoliMDPI AGarticlecase-controlcoronavirusSARS-CoV-2pneumothoraxpneumomediastinumCOVID-19MedicineRENJournal of Clinical Medicine, Vol 10, Iss 4835, p 4835 (2021) |
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| collection |
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| topic |
case-control coronavirus SARS-CoV-2 pneumothorax pneumomediastinum COVID-19 Medicine R |
| spellingShingle |
case-control coronavirus SARS-CoV-2 pneumothorax pneumomediastinum COVID-19 Medicine R Matteo Bonato Alessia Fraccaro Nicholas Landini Giuseppe Zanardi Cosimo Catino Francesca Savoia Nicola Malacchini Fabiola Zeraj Piera Peditto Vito Catalanotti Elisabetta Marcon Emanuela Rossi Alessia Pauletti Silvia Galvan Riccardo Adami Marta Tiepolo Mauro Salasnich Maria Cuzzola Francesca Zampieri Marcello Rattazzi Mario Peta Simonetta Baraldo Marina Saetta Giovanni Morana Micaela Romagnoli Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy |
| description |
Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients’ outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. Methods: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX/PNM were compared. Results: Among 1213 patients, PNX and/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX/PNM showed higher in-hospital (<i>p</i> = 0.02) and 90-days mortality (<i>p</i> = 0.048), and longer hospitalization length (<i>p</i> = 0.002) than COVID-19 patients without PNX/PNM. At PNX/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX/PNM occurrence was associated with longer symptom length before hospital admission (<i>p</i> = 0.005) and lower levels of blood lymphocytes (<i>p</i> = 0.017). Conclusion: PNX/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation. |
| format |
article |
| author |
Matteo Bonato Alessia Fraccaro Nicholas Landini Giuseppe Zanardi Cosimo Catino Francesca Savoia Nicola Malacchini Fabiola Zeraj Piera Peditto Vito Catalanotti Elisabetta Marcon Emanuela Rossi Alessia Pauletti Silvia Galvan Riccardo Adami Marta Tiepolo Mauro Salasnich Maria Cuzzola Francesca Zampieri Marcello Rattazzi Mario Peta Simonetta Baraldo Marina Saetta Giovanni Morana Micaela Romagnoli |
| author_facet |
Matteo Bonato Alessia Fraccaro Nicholas Landini Giuseppe Zanardi Cosimo Catino Francesca Savoia Nicola Malacchini Fabiola Zeraj Piera Peditto Vito Catalanotti Elisabetta Marcon Emanuela Rossi Alessia Pauletti Silvia Galvan Riccardo Adami Marta Tiepolo Mauro Salasnich Maria Cuzzola Francesca Zampieri Marcello Rattazzi Mario Peta Simonetta Baraldo Marina Saetta Giovanni Morana Micaela Romagnoli |
| author_sort |
Matteo Bonato |
| title |
Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy |
| title_short |
Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy |
| title_full |
Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy |
| title_fullStr |
Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy |
| title_full_unstemmed |
Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy |
| title_sort |
pneumothorax and/or pneumomediastinum worsens the prognosis of covid-19 patients with severe acute respiratory failure: a multicenter retrospective case-control study in the north-east of italy |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/ef777375d5864793842e51955b7a6253 |
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