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INTRODUCTION: COVID-19 can occasionally complicate into spontaneous pneumothorax (SP) and/or spontaneous pneumomediastinum (SM). This study aims at exploring the occurrence of SP and or SM, risk factors, and outcomes in COVID-19 patients. MATERIALS AND METHODS: All patients with COVID-19, which complicated into SP and/or SM at Hamad Medical Corporation (the principal public healthcare provider in Qatar) from March to September 2020, were retrospectively enrolled. The clinical diagnosis was confirmed by CXR and CT. Between-group comparisons were performed by using Chi-square and t-test. Differences were considered statistically significant at P ≤ .05. RESULTS: A total of 1100 patients were admitted, and 43 patients developed SP, SP + SM, or SM. Most patients were males (42/97.9%), and the most common comorbidity was diabetes mellitus (13/30.2%). All patients had acute respiratory distress syndrome (ARDS), and most patients had low lung compliance at the time of developing SP or SM. Twenty-two of the patients developed SP (51.2%), 11 patients had both SP and SM (25.6%), and 10 patients had SM only (23.3%). There was no significant difference in the development of SP or SM and patients' gender or blood group or whether patients were on invasive or noninvasive ventilation or even the mortality (P > .05). Lung compliance was significantly (P < .05) lower in patients complicated with SP and or SM. Patients with SP required significantly higher (P < .001) chest drain insertion. CONCLUSION: Patients with severe COVID-19 pneumonia can complicate into SP and SM. These complications are more common in male diabetic patients. Patients with ARDS and having low lung compliance are at a higher risk of developing SP, SP + SM, or SM.
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Background: Hemoptysis is an alarming symptom in clinical practice. We reviewed ten years of experience with hemoptysis in a tertiary hospital in Qatar to identify hemoptysis etiologies, patient characteristics, and associated factors. Methods: Hemoptysis was defined based on severity as mild ( < 50 ml or streaks of blood), moderate (50-150 ml) and massive (>150 ml) in the 24 hours before admission. Hemodynamically unstable is considered when systolic BP < 100 mmHg,tachycardia with HR>110/min, tachypnea with RR>22/min, or SpO2 < 92% on room air. Results: A total of 102 patients (41 females and 61 males) with 133 episodes of hemoptysis were identified in this study. Among the hemoptysis patients with co-morbidities, 19 patients had hypertension, 17 patients had cardiovascular disease, and 66 patients with other co-morbidities. COPD patients had a significant (p < 0.02) association with hemoptysis. Chest X-ray was used in most patients and other modalities like CT scan and bronchoscopies were used less frequently. Pneumonia (12.8%), bronchiectasis (11.8%) and cardiovascular disorders (11.8%) are the primary causes of hemoptysis. Malignancy was less frequent (7.8%), and bronchogenic carcinoma was uncommon (2%). There were 24 (23.5 %) no identified causes of hemoptysis. The overall mortality was 9.8% in this study. Conclusions: Population demographics played a significant role in the severity of hemoptysis and prognosis. Most patients had benign etiologies, lower severity of hemoptysis and good prognosis. Differences in the etiology, initial severity, and prognosis of patients with hemoptysis were found significantly different when compared with those reported in previous studies.
