Dataset Information

High incidence and mortality of pneumothorax in critically Ill patients with COVID-19.

ABSTRACT:

Background

The clinical characteristics of the patients with COVID-19 complicated by pneumothorax have not been clarified.

Objectives

To determine the epidemiology and risks of pneumothorax in the critically ill patients with COVID-19.

Methods

Retrospectively collecting and analysing medical records, laboratory findings, chest X-ray and CT images of 5 patients complicated by pneumothorax.

Results

The incidence of pneumothorax was 10% (5/49) in patients with ARDS, 24% (5/21) in patients receiving mechanical ventilation, and 56% (5/9) in patients requiring invasive mechanical ventilation, with 80% (4/5) patients died. All the 5 patients were male and aged ranging from 54 to 79 years old. Pneumothorax was most likely to occur 2 weeks after the beginning of dyspnea and associated with reduction of neuromuscular blockers, recruitment maneuver, severe cough, changes of lung structure and function.

Conclusions

Pneumothorax is a frequent and fatal complication of critically ill patients with COVID-19.

SUBMITTER: Wang XH

PROVIDER: S-EPMC7556825 | biostudies-literature | 2021 Jan - Feb

REPOSITORIES: biostudies-literature

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Publications

High incidence and mortality of pneumothorax in critically Ill patients with COVID-19.

Wang Xiao-Hui XH Duan Jun J Han Xiaoli X Liu Xinzhu X Zhou Junhao J Wang Xue X Zhu Linxiao L Mou Huaming H Guo Shuliang S

Heart & lung : the journal of critical care 20201014 1

<h4>Background</h4>The clinical characteristics of the patients with COVID-19 complicated by pneumothorax have not been clarified.<h4>Objectives</h4>To determine the epidemiology and risks of pneumothorax in the critically ill patients with COVID-19.<h4>Methods</h4>Retrospectively collecting and analysing medical records, laboratory findings, chest X-ray and CT images of 5 patients complicated by pneumothorax.<h4>Results</h4>The incidence of pneumothorax was 10% (5/49) in patients with ARDS, 24% ...[more]

PMID: 33138976

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Project description:BackgroundA substantial proportion of critically ill COVID-19 patients develop thromboembolic complications, but it is unclear whether higher doses of thromboprophylaxis are associated with lower mortality rates. The purpose of the study was to evaluate the association between initial dosing strategy of thromboprophylaxis in critically ill COVID-19 patients and the risk of death, thromboembolism, and bleeding.MethodIn this retrospective study, all critically ill COVID-19 patients admitted to two intensive care units in March and April 2020 were eligible. Patients were categorized into three groups according to initial daily dose of thromboprophylaxis: low (2500-4500 IU tinzaparin or 2500-5000 IU dalteparin), medium (> 4500 IU but < 175 IU/kilogram, kg, of body weight tinzaparin or > 5000 IU but < 200 IU/kg of body weight dalteparin), and high dose (≥ 175 IU/kg of body weight tinzaparin or ≥ 200 IU/kg of body weight dalteparin). Thromboprophylaxis dosage was based on local standardized recommendations, not on degree of critical illness or risk of thrombosis. Cox proportional hazards regression was used to estimate hazard ratios with corresponding 95% confidence intervals of death within 28 days from ICU admission. Multivariable models were adjusted for sex, age, body mass index, Simplified Acute Physiology Score III, invasive respiratory support, and initial dosing strategy of thromboprophylaxis.ResultsA total of 152 patients were included: 67 received low-, 48 medium-, and 37 high-dose thromboprophylaxis. Baseline characteristics did not differ between groups. For patients who received high-dose prophylaxis, mortality was lower (13.5%) compared to those who received medium dose (25.0%) or low dose (38.8%), p = 0.02. The hazard ratio of death was 0.33 (95% confidence intervals 0.13-0.87) among those who received high dose, and 0.88 (95% confidence intervals 0.43-1.83) among those who received medium dose, as compared to those who received low-dose thromboprophylaxis. There were fewer thromboembolic events in the high (2.7%) vs medium (18.8%) and low-dose thromboprophylaxis (17.9%) groups, p = 0.04.ConclusionsAmong critically ill COVID-19 patients with respiratory failure, high-dose thromboprophylaxis was associated with a lower risk of death and a lower cumulative incidence of thromboembolic events compared with lower doses.Trial registrationClinicaltrials.gov NCT04412304 June 2, 2020, retrospectively registered.

Dataset Information

High incidence and mortality of pneumothorax in critically Ill patients with COVID-19.

Background

Objectives

Methods

Results

Conclusions

Publications

High incidence and mortality of pneumothorax in critically Ill patients with COVID-19.

Similar Datasets

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