SESSION TITLE: Chest Infections Posters
SESSION TYPE: Original Investigation Posters
PRESENTED ON: October 18-21, 2020
PURPOSE: Approximately 1% of patients admitted for SARS-CoV-2 may develop pneumothorax (PTX) during the hospitalization. Currently there is no literature available regarding the development of pneumothorax during SARS-CoV-2 infection neither the characteristics nor clinical outcomes of these patients. We present a single center review of 11 subjects who developed PTX during the course of hospitalization for SARS-CoV-2.
METHODS: Retrospective medical records review of patients diagnosed with PTX and SARS-CoV-2 between January 1, 2020 and May 8, 2020 at Beth Israel Deaconess Medical Center in Boston, MA. Patients were identified from our institutional database (Clinical Query 2). Demographics, baseline comorbidities, hospital stay, ICU stay, interventions and crude mortality are presented.
RESULTS: A total of 11 inpatients with SARS-CoV-2 and PTX were included (mean age 66.45 years [SD 13.28]; 81.82% [n=9] males; 72.73% PTX on the right side). The mean hospital stay until discharge or death was 25.91 days (SD 11.61), with a mean time from admission to PTX of 13.81 days (SD 12.27). Nine (81.82%) of PTX were secondary spontaneous and 2 (18.18%) iatrogenic. The most common comorbid conditions found were hypertension (54.55%) followed by hyperlipidemia (45.45%), malignancy (27.27%) and congestive heart failure (27.27%). Nine (81.81%) subjects were on the ICU when the event occurred with a mean ICU stay of 15.11 days (SD 8.89). Seven (63.64%) patients were under mechanical ventilation with a mean intubation time of 19.86 days (SD 10.17). Ten (90.91%) subjects required chest tube insertion with 54.54% (n=6) requiring chest tube size > 14 Fr. Two (18.18%) patients ended up having tracheostomy and 5 (45.45%) died before discharge.
CONCLUSIONS: We found that secondary and iatrogenic PTX may be an infrequent complication of patients admitted for the treatment of SARS-CoV-2. This entity may be implicated in acute clinical deterioration with rapid oxygen desaturation in critically ill patients.
CLINICAL IMPLICATIONS: Pneumothorax may be may be implicated in acute clinical deterioration with rapid oxygen desaturation in critically ill patients SARS-CoV-2.
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