ABSTRACT
This study evaluated cases of spontaneous pneumothorax developing secondary to SARS-CoV-2 pneumonia. Sixteen cases presenting to our hospital due to spontaneous pneumothorax developing secondary to SARS-CoV-2 pneumonia between March 2020 and February 2020 were evaluated retrospectively. Ten patients (62.5%) were men, and six (37.5%) were women, with a mean age of 68 .. 20.3 years (range 18 - 90 years). Pneumothorax was in the right hemithorax in 11 cases (68.75%), in the left hemithorax in two (12.5%), and bilateral in three (17.75%). Pneumothorax developed during active SARS-CoV-2 pneumonia in all 16 cases (100%). No pneumothorax was detected following the healing of SARS-CoV-2 infection. Pneumothorax was observed while patients were not intubated in 15 cases (93.75%), but pneumothorax developed during mechanical ventilation in one case (6.25%). Tube thoracostomy was performed on all patients in treatment. Air leakage from the tube was observed in 14 cases (87.5%). The mean duration of tube thoracostomy was 18.3 .. 20.1 days (range 1 - 81 days). Pneumothorax resolved after treatment in seven cases (43.75%), while mortality occurred in nine (56.25%). Pneumothorax recurred after treatment in one case (6.25%). Pneumothorax is widely seen in the active period or after healing in cases infected with COVID-19. Aggressive treatment is generally required for this clinical manifestation with high mortality.
ABSTRACT
BACKGROUND: COVID-19 pandemic spread around the world like an infectious disease that presents waved effects on patients. Some patients needed ICU and respiratory support. Some patients only had flu-like symptoms. Cytokine storm and elevated ROS were serious problems for treatment. Apoptotic genes and CYP Family are part of these mechanisms. AIM: In this study, our aim was to examine the gene expression CYP2E1 and Caspase-3 in patients with COVID-19 infection. METHOD: 60 COVID-19(+) patients (ICU and non-ICU patients) and 30 healthy volunteers were enrolled to study. To measure the level of gene expression qPCR was used. The 2-ΔΔCt method was utilized to analyze gene expression. RESULTS: The expression of CYP2E1 and Caspase-3 genes showed a significant discrepancy between patients and healthy individuals. Caspase-3 expression increased (p=0,0041) but CYP2E1 expression decreased (p=0,0214) in COVID-19 patients compared to healthy individuals. Both levels of gene expression were lower in patients with affected lungs than patients with unaffected lungs (p<0,05). Laboratory findings including d-Dimer, LDH, platelet count, lymphocyte count were related to both gene expressions (p<0,05). We found no correlation between CYP2E1 and Caspase-3 expressions. CONCLUSION: The expression of Caspase-3 demonstrated apoptotic situations of patients but was not related to the CYP2E1 expression level. CYP2E1 gene expression is an important actor to metabolize endogens and xenobiotics however, COVID-19 patients demonstrated decreased CYP2E1 expression. CYP2E1 and Caspase-3 gene expression levels may be used as a diagnostic tool for COVID-19 patients.