Abstract
Introduction: Pneumothorax (PTX) and pneumomediastinum (PM) occur in COVID-19 (rates PTX: 1% on ward, 2% on intensive care units and 1% in dying patients). Patients are male non-smokers with no respiratory co-morbidities and variable BMI and height. 63% survive. We sought to understand the experience in Northumbria Healthcare NHS Foundation Trust.
Methods: With Caldiocott approval, the records of Covid-19 inpatients were analysed to identify patients with PTX and PM. Demographics and outcomes were collected.
Results: 22 were identified (Total: 2241, 01/03/20-10/02/21): mean age 64.5 years (range 29-91). 18 (81.8%) male, 21 white Caucasian, 1 South East Asian, 11 ex-smokers, 3 never smokers, 1 current smoker & 7 unknown. Respiratory comorbidity was COPD (3), asthma (2), combined pulmonary fibrosis and emphysema (1), previous TB (1), & active lung cancer (1). Average estimated frailty score was 2.4 (range 1-6). Mean BMI was 27.3 (range 18.5-46.7), mean height 1.72m (range 1.55-1.84). 17 patients had PTX [12 isolated PTX (3 left, 7 right, 2 bilateral)] & 10 had PM. 5 had both PM & PTX. 5 patients were intubated at the time of PM, 4 on CPAP, 7 on oxygen, 5 on air and 1 unknown. 14 were managed conservatively. Others had a variety of small, large bore and subcutaneous drains and 1 was transferred for ECMO. There were 10 deaths with 1 directly due to PTX in a 91 yr old, CFS of 6 and intercurrent stroke. 1 was associated with PM, CFS 2 & lung cancer, 1 85 yr old with CFS 4 & COPD, 1 82 yr old with CFS 3 on CPAP & the rest were on mechanical ventilation).
Conclusions: Inpatient incidence of PTX and PM is 0.98%. Survival is lower (54.5%) but difficult to compare in the presence of frailty and co-morbidities.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA442.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021