COVID-19 Related "Pneumo" Complications: Regional Hospital Experience

Background: Coronavirus disease 2019 (COVID-19) presents from mild infection to severe pneumonia and ?pneumo? complications such as pneumothorax (PNTX) and pneumomediastinum (PNM). The aim was to discuss the incidence, characteristics, and outcomes of PNTX/PNM in COVID-19 pneumonia. Methods: This was a prospective observational study. We enrolled adult patients with COVID-19 pneumonia treated at The COVID hospital, University Clinical Center of Vojvodina, Serbia from 1st September to 2nd December 2021. We collected data on demographic, clinical characteristics, and outcomes of patients with COVID-19 pneumonia and PNTX/PNM. Results: From total number (3117) of patients 44 (1.41%) had PNTX and/or PNM; mean age 63.7?14; dominantly males (n=29, 65.9%).4 (9%) patients had chronic pulmonary disease (one asthma, three chronic obstructive pulmonary disease of which one combined with bronchiectasis) and 15 (34.0%) were active or ex smokers. Clinical characteristics were that 31 (70.4%) had PNTX, 6 (13.6%) had PNM and 7 (15.9%) patients had combined PNTX and PNM. PNTX isolated or combined with PNM was right sided in 23 (52. %), left sided in 12 (27.2%) and bilateral in 3 (6.8%) patients. PNTX/PNM was associated with subcutaneous emphysema in 4 (9.0%) cases. Approximately two-thirds of patients were ventilated (n=1, 2.2% non-invasively and n=29, 65.9% invasively). The remaining patients were oxygen-supported only: 5 (11.3%) conventional oxygen support, 8 (18.1%) high-flow nasal cannula.35 (79.5%) out of the total 44 cases were deceased during hospitalization. Conclusions: Incidence of PNTX and/or PNM was relatively low, it was not associated with underlining pulmonary diseases or smoking, but with high in-hospital mortality.