RESUMEN
There were over 400 million people with COVID-19 pneumonia worldwide and over 12 million in the Russian Federation after 2020. Complicated course of pneumonia with abscesses and gangrene of lungs was observed in 4% of cases. Mortality ranges from 8 to 30%. We report 4 patients with destructive pneumonia following SARS-CoV-2 infection. In one patient, bilateral lung abscesses regressed under conservative treatment. Three patients with bronchopleural fistula underwent staged surgical treatment. Reconstructive surgery included thoracoplasty with muscle flaps. There were no postoperative complications that required redo surgical treatment. We observed no recurrences of purulent-septic process and mortality.
Asunto(s)
Fístula Bronquial , COVID-19 , Enfermedades Pleurales , Neumonía , Humanos , COVID-19/complicaciones , SARS-CoV-2 , Neumonía/complicaciones , Fístula Bronquial/cirugía , Enfermedades Pleurales/etiologíaRESUMEN
Bronchopleural fistula (BPF) is associated with high morbidity if left untreated. Although rare, the frequency of BPF in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is becoming recognized in medical literature. We present a case of a 64-year-old male with BPF with persistent air leak due to SARS-CoV-2 pneumonia treated with Spiration Valve System endobronchial valve (EBV). An EBV was placed in the right middle lobe with successful cessation of air leak. In conclusion, the use of EBVs for BPF with persistent air leaks in SARS-CoV-2 patients who are poor surgical candidates is effective and safe.
Asunto(s)
Fístula Bronquial/cirugía , Broncoscopía , COVID-19/complicaciones , Empiema Pleural/cirugía , Enfermedades Pleurales/cirugía , Instrumentos Quirúrgicos , Fístula Bronquial/etiología , Tubos Torácicos , Empiema Pleural/etiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Pleurales/etiología , SARS-CoV-2 , ToracostomíaRESUMEN
We report a case of necrotizing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia complicated by a bronchopleural fistula and treated by decortication and salvage lobectomy. Owing to the unknown characteristics of the underlying SARS-CoV-2 infection, treatment of the abscess and bronchopleural fistula was delayed. This may have resulted in further deterioration of the patient, with ensuing multiple organ dysfunction. Complications of SARS-CoV-2 pneumonia, such as a bacterial abscess and a bronchopleural fistula, should be treated as if the patient were not infected with SARS-CoV-2.