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.