Retrospective Analysis of Spontaneous Pneumothorax Cases Associated with COVID-19

ABSTRACT Introduction: Spontaneous pneumothorax is the presence of air in the pleural space without a history of trauma. The risk of developing spontaneous pneumothorax was 40 to 100 times higher in patients with COVID-19 compared to those without. Objective: Within the scope of this research, we aimed to elucidate spontaneous pneumothorax cases associated with COVID-19 in a retrospective manner. Method: Patients diagnosed with COVID-19 and spontaneous pneumothorax at our were included in this retrospective analysis. The patients' admission complaints, comorbidities, COVID-19, RT-PCR results, laboratory findings, imaging results, treatment methods applied, and hospitalization or discharge were recorded. Results: A total of 31 patients aged between 21 and 90 were included in the analysis. Patients were divided into two subgroups: discharge (n=20) and exitus (n=11). While the average hospitalization period of the discharge group was 14.7±22/days, the average hospitalization period of the exitus group was calculated as 2.6±2.1/days (p<0.001). While 15 (75%) patients in the discharge group required intensive care follow-up, all in the exitus group required intensive care follow-up (p =0.133). A statistically significant difference was detected between the mean values of hemoglobin, INR, D-Dimer, and PLT in the laboratory examinations of the discharge group and the exitus group (p-value; 0.022, 0.004, 0.005, and 0.042, respectively). It was found that there was a strong positive relationship between the length of hospital stay of the patients and laboratory findings, PLR, and NLR (correlation coefficient: 0.818 and 0.818, respectively). Conclusion: Although many different clinical conditions that develop during COVID-19 infection are in the literature, cases of pneumothorax and pneumomediastinum have been rarely reported. In addition, the possibility of high mortality in these clinical conditions that may be seen in the actively ongoing COVID-19 pandemic should also be taken into consideration. Keyswords: Pneumothorax, COVID-19, Intensive Care Unit, D-dimer, Acute Respiratory Distress Syndrome.