The relationship between COVID-19 and pneumothorax in patients hospitalized during the pandemic

Objective: We aimed to determine the incidence, demographic characteristics, and risk factors of "spontaneous pneumothorax (SP)" that we detected in severe COVID-19 patients with acute respiratory distress (ARDS) who were followed up in the intensive care unit (ICU) of our hospital. Methods: This is a retrospective observational study conducted on adult COVID-19 patients admitted to our hospital between March 11, 2020, and December 31, 2021. The cases were patients who were hospitalized in the ICU with the diagnosis of COVID-19 and developed pneumothorax. Chest radiography (CXR) and computed tomography (CT) were used to diagnose pneumothorax. The medical records contained detailed demographic information, radiography images, laboratory data, and information on treatment management and survival. Results: A total of 20 patients hospitalized in the ICU with the diagnosis of COVID-19 developed pneumothorax. Of these patients, 11 (55%) were male and 9 (45%) were female. Based on our findings, 90% of the patients developed spontaneous pneumothorax during their COVID-19 disease and 10% during their post-COVID follow-up. The radiologic examination of pneumothorax patients revealed that 70% were right-sided, 15% were left-sided, and 15% were bilateral. Regarding the treatment protocol of the patients, chest drain treatment was used in 85%, while 15% were followed up with oxygen treatment. The incidence of pneumothorax was higher in males. Conclusion: These cases suggest that pneumothorax is a complication of COVID-19. Spontaneous pneumothorax is a rare complication of COVID-19 viral pneumonia. Sudden clinical changes in patients during intensive care follow-up should be considered a preliminary diagnosis. Clinicians should be careful about the diagnosis and treatment of this complication