ABSTRACT
Background: At our hospital, people with COVID-19 (coronavirus disease 2019) had a high rate of pulmonary barotrauma. Therefore, the current study looked at barotrauma in COVID-19 patients getting invasive and non-invasive positive pressure ventilation to assess its prevalence, clinical results, and features. Methodology: Our retrospective cohort study comprised of adult COVID-19 pneumonia patients who visited our tertiary care hospital between April 2020 and September 2021 and developed barotrauma. Result(s): Sixty-eight patients were included in this study. Subcutaneous emphysema was the most frequent type of barotrauma, reported at 67.6%;pneumomediastinum, reported at 61.8%;pneumothorax, reported at 47.1%. The most frequent device associated with barotrauma was CPAP (51.5%). Among the 68 patients, 27.9% were discharged without supplemental oxygen, while 4.4% were discharged on oxygen. 76.5% of the patients expired because of COVID pneumonia and its complications. In addition, 38.2% of the patients required invasive mechanical breathing, and 77.9% of the patients were admitted to the ICU. Conclusion(s): Barotrauma in COVID-19 can pose a serious risk factor leading to mortality. Also, using CPAP was linked to a higher risk of barotrauma.Copyright © 2021 Muslim OT et al.
ABSTRACT
BACKGROUND: Coronavirus Disease 19 (COVID-19) damages the lungs and may potentially culminate in acute respiratory distress syndrome (ARDS). Several therapy strategies, including corticosteroids, have been attempted across the world with favorable results. However, the most suitable corticosteroid type and dose for COVID-19 treatment remain undefined. Therefore, we performed a study to retrospectively compare the efficacy of two popular corticosteroid therapies: dexamethasone and methylprednisolone, in treating severe COVID-19 pneumonia. METHODS: This observational retrospective cohort analysis comprised 1001 patients diagnosed with an established diagnosis of severe COVID-19 pneumonia who were hospitalized to a tertiary care hospital, Dr. Ziauddin Hospital North Nazimabad, Karachi, Pakistan, from April 2020 through February 2021. RESULTS: Between the two study groups, no significant difference was reported in patient mortality. A significantly higher percentage of MTP patients required admission to the ICU (194 (33.0%) vs. 89 (21.5%);P- < 0.001). Patients in the DXM group had significantly lower chances of being admitted to the ICU (OR: 0.419, 95% CI: 0.273-0.642;P- < 0.001), supported by a significantly lower risk of the need of ICU admission (HR 0.538, 95% CI: 0.383-0.755;P- < 0.001). Additionally, on Kaplan-Meier analysis, the DXM group patients received discharge from the hospital significantly earlier (6.83 vs. 8.20 days;Log Rank P-0.003) and required ICU admission much later (5.01 vs. 2.40 days;Log Rank P- < 0.001). CONCLUSION: Dexamethasone was found to have a significant reduction in the need for intensive care unit admission as well as early hospital discharge.