Spontaneous tension pneumomediastinum with pneumothorax and subcutaneous emphysema as a complication of COVID-19 Disease (preprint)

Recently spontaneous tension pneumomediastinum (PTM), pneumothorax (PT), and subcutaneous emphysema (SE) were reported as infrequent complications in COVID-19 patients. Early diagnosis and treatment could save the patients since these complications are related to poor prognosis and prolonged hospitalization. Here we report these complications in an Iranian patient.

The Predictors of COVID-19 Disease Outcomes in Health Care Workers (preprint)

Introduction: The COVID-19 has been associated with many problems for the general public and especially health care workers (HCWs). This study conducted to provide predictors of COVID-19 outcomes on HCWs in Rasht, Iran. Methods: In a retrospective cross-sectional study, 381 HCWs with positive RT-PCR or high-resolution lungs computed tomography for COVID-19 from February 21 to April 19, 2020 evaluated. The prevalence, demographic, clinical, laboratory, and radiological presentations and outcomes and their correlation were studied. Results: The prevalence of COVID-19 in HCWs was 5.62%, and the total mortality rate was 0.2%. The mortality rates were different between genders ( P =0.002) and in general ward compared to intensive care unit ( P =0.001). In the multivariate analysis, age (OR:1.12, 95%CI 1.02–1.23, P =0.014), diabetes mellitus (DM) (OR:10.73, 95%CI 1.91–60.3, P =0.007), blood group B (OR:19.2, 95%CI 1.8–199.984, P =0.013), the presence of peribronchovascular involvement (OR:1.1, 95% CI OR:1.02–1.2, P =0.019), dyspnea on admission (OR:1.05, 95%CI 1.01–1.09, P =0.013), higher neutrophil count (OR:1.09, 95%CI 1.04–1.14, P <0.001), higher level of alkaline phosphatase (OR:1, 95%CI 1.001–1.002, P =0.001), and longer prothrombin time (OR:1.027, 95%CI 1.008–1.046, P =0.005) increase the risk of mortality. The cutoff of 90% for oxygen saturation on admission (sensitivity=91.9%, specificity=88.9%) and 1004 for absolute lymphocyte count (sensitivity=81.8%, specificity=66.6%) were estimated as predictors of mortality. Conclusions: Old age, male sex, underlying disease of DM and hypertension, O 2 saturation less than 90%, and absolute lymphocyte count less than 1004/mL in HCWs are prone to adverse outcomes such as the need for mechanical ventilation or death.