Spontaneous pneumothorax as a complication of COVID-19 pneumonia – self-experience study

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Introduction: Spontaneous pneumothorax is a rare complication of COVID-19 pneumonia (only 1–2% of patients). The aim of this research is to present this pathological entity as a complication of COVID-19 pneumonia. Patients and Methods: We present 18 patients (hospitalized from August to December 2020) with spontaneous pneumothorax as a complication of COVID-19 pneumonia [sex: men -11(61,1 %); mean age – 67,83, range: 33 ÷ 88 years].Imagine methods (X-Ray and computed tomography) were used to determine COVID-19 pneumonia and pneumothorax. Pneumothorax was treated by chest tube insertion. Results: Right-sided pneumothorax was established in 10 patients (55,6%), left-sided – in 6 (33,3 %) and bilateral – in 2. In 13 patients there was a connection between pneumothorax and mechanical ventilation: in nine of the patients pneumothorax was presented during the ventilation and for the rest four cases after patient’s extubation - as a late sequel of COVID-19 pneumonia. In five of the cases, spontaneous pneumothorax wasn’t related with mechanical ventilation. The cumulative death rate was 72,22 % (in 13 patients): 11 of them - from the group with mechanical ventilation and in 2 cases - without intubation. Conclusion: With this research we present one relatively rare complication of COVID-19 pneumonia – spontaneous pneumothorax. Our results demonstrate the role of mechanical ventilation as a precipitating factor for spontaneous pneumothorax in COVID-19 patients. In spite of the limited number of reported cases, this study presents mechanical ventilation as a risk factor for patient’s death in COVID-19 pneumonia complicated with spontaneous pneumothorax.

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