Epidemiological and outcome analysis of COVID-19-associated pneumothorax: multicentre retrospective critical care experience from Qatar.
BMJ Open
; 12(2): e053398, 2022 02 21.
Article
in English
| MEDLINE | ID: covidwho-1709529
ABSTRACT
OBJECTIVES:
To study the incidence, characteristics, treatment, associated risk factors and outcome of COVID-19-associated pneumothorax in intensive care unit (ICU).DESIGN:
Retrospective observational data review.SETTING:
A multicentre study from ICUs of three tertiary care hospitals in Qatar.PARTICIPANTS:
1788 patients with COVID-19 pneumonia requiring ICU admission from 1 March 2020 to 1 November 2020 were enrolled in this study.INTERVENTIONS:
Not applicable. PRIMARY AND SECONDARY OUTCOMEMEASURES:
The primary endpoint was to identify the incidence of COVID-19-associated pneumothorax in patients requiring ICU admission. Secondary endpoints were to determine the associated risk factors, treatment, mortality and morbidity.RESULTS:
1788 patients from 3 centres were reviewed in the study. The total episodes of pneumothorax were 75. Pneumothorax occurred in 4.2% of the patients with COVID-19 pneumonia requiring ICU admission. The majority of the subjects were male (n=72, 96%). The mean age was 55.1 (±12.7 years). The majority of the subjects were nationals of South Asian countries and the Middle East and North Africa regions. 52% (n=39) of the patients were previously healthy without comorbidities before ICU admission. The recurrence rate was 9.3%. The median length of ICU stay was 28 days (20.5-45.8 days). After developing pneumothorax, the length of mechanical ventilation ranged from 6 to 32 days, with a median of 13 days. 44% of patients eventually ended up with tracheostomy. In-hospital mortality in the patients with COVID-19-related pneumothorax was 53.3% (n=40). The odds of mortality in patients with COVID-19 pneumonia with pneumothorax is 7.15 (95% CI 4.45 to 11.48, p<0.0001) compared with those who did not develop pneumothorax. This indicates pneumothorax is a potential independent risk factor associated with mortality in patients with COVID-19 pneumonia requiring ICU admission.CONCLUSIONS:
Pneumothorax is a common complication in patients with COVID-19 requiring ICU admission, associated with poor prognosis and outcome. TRIAL REGISTRATION NUMBER The study was approved by the Medical Research Centre (MRC) Qatar. (MRC-01-20-1116).Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumothorax
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
English
Journal:
BMJ Open
Year:
2022
Document Type:
Article
Affiliation country:
Bmjopen-2021-053398
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