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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.
Bonato, Matteo; Fraccaro, Alessia; Landini, Nicholas; Zanardi, Giuseppe; Catino, Cosimo; Savoia, Francesca; Malacchini, Nicola; Zeraj, Fabiola; Peditto, Piera; Catalanotti, Vito; Marcon, Elisabetta; Rossi, Emanuela; Pauletti, Alessia; Galvan, Silvia; Adami, Riccardo; Tiepolo, Marta; Salasnich, Mauro; Cuzzola, Maria; Zampieri, Francesca; Rattazzi, Marcello; Peta, Mario; Baraldo, Simonetta; Saetta, Marina; Morana, Giovanni; Romagnoli, Micaela.
  • Bonato M; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Fraccaro A; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy.
  • Landini N; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Zanardi G; Department of Radiology, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Catino C; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Savoia F; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Malacchini N; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Zeraj F; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Peditto P; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Catalanotti V; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Marcon E; IRCCS Azienda Ospedaliera-Universitaria, Division of Respiratory and Critical Care Sant'Orsola Hospital, 40141 Bologna, Italy.
  • Rossi E; Pulmonology Unit, Ospedale di Vittorio Veneto, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31029 Vittorio Veneto, Italy.
  • Pauletti A; Pulmonology Unit, Ospedale di Montebelluna, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31044 Montebelluna, Italy.
  • Galvan S; Pulmonology Unit, Ospedale di Montebelluna, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31044 Montebelluna, Italy.
  • Adami R; Internal Medicine II, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Tiepolo M; Geriatric Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Salasnich M; Internal Medicine I, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Cuzzola M; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Zampieri F; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Rattazzi M; Pulmonology Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Peta M; Internal Medicine I, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Baraldo S; Intensive Care Unit, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Saetta M; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy.
  • Morana G; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy.
  • Romagnoli M; Department of Radiology, Ospedale Cà Foncello, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
J Clin Med ; 10(21)2021 Oct 21.
Article in English | MEDLINE | ID: covidwho-1480814
ABSTRACT
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 (p = 0.02) and 90-days mortality (p = 0.048), and longer hospitalization length (p = 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 (p = 0.005) and lower levels of blood lymphocytes (p = 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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10214835

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10214835