Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case-control study.
BMC Infect Dis
; 23(1): 137, 2023 Mar 07.
Article
in English
| MEDLINE | ID: covidwho-2268335
ABSTRACT
BACKGROUND:
During the novel coronavirus disease-2019 pandemic, a considerable number of pneumothorax (PNX)/pneumomediastinum (PNM) associated with COVID-19 have been reported, and the incidence is higher in critically ill patients. Despite using a protective ventilation strategy, PNX/PNM still occurs in patients on invasive mechanical ventilation (IMV). This matched case-control study aims to identify the risk factors and clinical characteristics of PNX/PNM in COVID-19.METHODS:
This retrospective study enrolled adult patients with COVID-19, admitted to a critical care unit from March 1, 2020, to January 31, 2022. COVID-19 patients with PNX/PNM were compared, in a 1-2 ratio, to COVID-19 patients without PNX/PNM, matched for age, gender, and worst National Institute of Allergy and Infectious Diseases ordinal scale. Conditional logistic regression analysis was performed to assess the risk factors for PNX/PNM in COVID-19.RESULTS:
427 patients with COVID-19 were admitted during the period, and 24 patients were diagnosed with PNX/PNM. Body mass index (BMI) was significantly lower in the case group (22.8 kg/m2 and 24.7 kg/m2; P = 0.048). BMI was statistically significant risk factor for PNX/PNM in univariate conditional logistic regression analysis [odds ratio (OR), 0.85; confidence interval (CI), 0.72-0.996; P = 0.044]. For patients on IMV support, univariate conditional logistic regression analysis showed the statistical significance of the duration from symptom onset to intubation (OR, 1.14; CI, 1.006-1.293; P = 0.041).CONCLUSIONS:
Higher BMI tended to show a protective effect against PNX/PNM due to COVID-19 and delayed application of IMV might be a contributive factor for this complication.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumothorax
/
COVID-19
/
Mediastinal Emphysema
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Humans
Language:
English
Journal:
BMC Infect Dis
Journal subject:
Communicable Diseases
Year:
2023
Document Type:
Article
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