Spontaneous pneumothorax secondary to barotrauma in COVID 19, case series and literature review.

Abstract

Introduction. It is widely known that Coronavirus Disease 2019 (COVID 19) can cause a Severe Acute Respiratory Syndrome, however there are certain extrapulmonary complications that can occur in the context of these patients such as pneumothorax, which despite having a reduced incidence, some case studies have reported high mortality. Pneumothorax in patients with COVID 19 can present spontaneously or induced by barotrauma by invasive and non-invasive mechanical ventilation. Objective. To determine the clinical, laboratory and imaging characteristics of a group of patients who were hospitalized for pneumonia due to COVID 19 and who in turn presented as a complication of pneumothorax, within the period February to July 2021 at the Ambato Regional Hospital. Methodology. We check the clinical reports of the patients with COVID 19 admitted to the Ambato Regional Hospital for the period of time established previously, who had a diagnosis of pneumothorax, those with a traumatic origin were excluded, obtaining 3 cases; in addition to conducting a current review of the bibliography in relation to the subject. Results. A total of 6 patients had a diagnosis of pneumothorax plus COVID 19, of which two patients were excluded because the cause of their pneumothorax was considered traumatic (traffic accidents), 1 of the patients was discarded due to insufficient data on the outcome its clinical evolution; of the rest of the three presented in the article: 2 presented spontaneous pneumothorax in a late stage of the disease, one of whom died; 1 showed a pneumothorax associated with barotrauma due to invasive mechanical ventilation with a favorable clinical course. Conclusion. Pneumothorax, despite being an infrequent complication in the spectrum of COVID-19 disease, must be addressed within the differential diagnosis when a patient presents sudden respiratory decompensation; further studies are required to determine whether pneumothorax in these patients leads to higher mortality, since the reports in the current literature are based on a series of isolated cases.