Abstract
Aim: The aim of this study is to evaluate the relationship between COVID-19 and spontaneous pneumothorax and shed light on
future research. Pneumothorax is the presence of free air between the visceral and parietal pleural layers. Primary spontaneous
pneumothorax is more common in young individuals, while secondary spontaneous pneumothorax is more prevalent in the elderly
population (age > 55). The treatment goal for pneumothorax is to remove the air in the pleural space and prevent its recurrence.
Due to the effects of the novel coronavirus disease 2019 (COVID-19) on the lungs, an increased risk of spontaneous pneumothorax
is expected. In most reported cases of pneumothorax associated with COVID-19, there are no traditional risk factors or underlying
predisposing lung diseases.
Material and Methods: Patients who applied to Kayseri City Hospital with the diagnosis of spontaneous pneumothorax between
March 12, 2017 and March 12, 2023 were retrospectively examined through hospital records. Patients were assessed based on age,
gender, primary and secondary pneumothorax status, smoking history, body mass index (BMI), administered treatments, length of
hospital stay, COVID-19 PCR positivity, and recurrence criteria. These criteria were compared before and after COVID-19.
Results: A total of 160 patients presented before COVID-19, while 138 patients presented after COVID-19. Among the patients
who presented before COVID-19, 140 (87%) were male, and 20 (13%) were female. Among the 138 patients who presented after
COVID-19, 124 (89%) were male, and 14 (11%) were female. When looking at the average ages of the patients, the pre-COVID-19
average age was 25, while the post-COVID-19 average age was 28. Out of the 160 patients who presented before COVID-19, 111
(69%) had primary spontaneous pneumothorax, and 49 (31%) had secondary spontaneous pneumothorax. After COVID-19, out of
the 138 patients, 108 (78%) had primary spontaneous pneumothorax, and 30 (22%) had secondary spontaneous pneumothorax.
Conclusion: In conclusion, COVID-19 increases the risk of spontaneous pneumothorax not only due to chronic inflammation and
fibrosis in the lungs but also because of bullae and bleb formation. The pathophysiology of COVID-19 and spontaneous pneumothorax
remains unclear. This study will pave the way for further research in this field.
References
- 1. Sahn SA, Heffner JE. Spontaneous pneumothorax. New England Journal of Medicine. 2000;342(12):868-74.
- 2. Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax. 2000;55(8):666-71.
- 3. Olesen WH, Titlestad IL, Andersen PE, Lindahl-Jacobsen R, Licht PB. Incidence of primary spontaneous pneumothorax: a validated, register-based nationwide study. ERJ Open Res. 2019;5(2):00022-2019.
- 4. Bobbio A, Dechartres A, Bouam S, Damotte D, Rabbat A, Régnard JF, et al. Epidemiology of spontaneous pneumothorax: gender-related differences. Thorax. 2015;70(7):653-8.
- 5. Hallifax R. Aetiology of primary spontaneous pneumothorax. Journal of Clinical Medicine. 2022;11(3):490.
- 6. Bonilla A, Blair AJ, Alamro SM, Ward RA, Feldman MB, Dutko RA, et al. Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: A case report and review of the literature. Journal of Medical Case Reports. 2019;13(1):1-6.
- 7. Bense L, Eklund G, Wiman LG. Smoking and the increased risk of contracting spontaneous pneumothorax. Chest. 1987;92(6):1009-12.
- 8. Henry M, Arnold T, Harvey J. BTS guidelines for the management of spontaneous pneumothorax. Thorax. 2003;58(2):ii39.
- 9. Lipscomb VJ, Hardie RJ, Dubielzig RR. Spontaneous pneumothorax caused by pulmonary blebs and bullae in 12 dogs. Journal of the American Animal Hospital Association. 2003;39(5):435-45.
- 10. Sattler A. Zur behandlung des spontanpneumothorax mit besonderer berücksichtigung der thorakoskopie. Beiträge zur Klinik der Tuberkulose und spezifischen Tuberkulose-Forschung. 1937;89:395-408.
- 11. O’Rourke JP, Yee ES. Civilian spontaneous pneumothorax: treatment options and long-term results. Chest. 1989;96(6):1302-6.
- 12. Noppen M, Alexander P, Driesen P, Slabbynck H, Verstraeten A. Manual aspiration versus chest tube drainage in first episodes of primary spontaneous pneumothorax: a multicenter, prospective, randomized pilot study. American Journal of Respiratory and Critical Care Medicine. 2002;165(9):1240-4.
- 13. Margolis M, Gharagozloo F, Tempesta B, Trachiotis GD, Katz NM, Alexander EP. Video-assisted thoracic surgical treatment of initial spontaneous pneumothorax in young patients. The Annals of Thoracic Surgery. 2003;76(5):1661-4.
- 14. Almind M, Lange P, Viskum K. Spontaneous pneumothorax: comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis. Thorax. 1989;44(8):627-30.
- 15. Ciotti M, Ciccozzi M, Terrinoni A, Jiang W-C, Wang C-B, Bernardini S. The COVID-19 pandemic. Critical Reviews in Clinical Laboratory Sciences. 2020;57(6):365-88.
- 16. Madabhavi I, Sarkar M, Kadakol N. COVID-19: A review. Monaldi Archives for Chest Disease. 2020;90(2).
- 17. Lyu R, Li X. Diagnosis and treatment of severe COVID-19 complicated with spontaneous pneumothorax: A case report. Advanced Ultrasound in Diagnosis and Therapy. 2020;4(2):142-6.
- 18. Mittal A, Sabharwal S, Foley R. Bullous lung disease complicating COVID-19 pneumonia. Chest. 2021;160(4):A908.
Abstract
Amaç: Pnömotoraks; viseral ve paryetal plevra katmanları arasında serbest hava olmasıdır. Primer spontan pnömotoraks daha
çok gençlerde görülürken; sekonder spontan pnömotoraks daha çok yaşlı (yaş>55) nüfusta gözlenir. Pnömotoraks tedavisinde hedef
plevral boşlukta bulunan havanın çıkarılması ve tekrar pnömotoraks oluşmamasıdır. Yeni korona virüs hastalığı 2019’un (COVID-19) akciğerde yarattığı etkiler nedeniyle spontan pnömotoraks riskini arttırması beklenir. COVID-19 ile ilişkili bildirilen pnömotoraks vakalarının çoğunda geleneksel risk faktörleri veya altta yatan predispozan akciğer hastalığı yoktur. Bu çalışmanın amacı;
COVID-19 un spontan pnömotoraks ile ilişkisini değerlendirmek ve sonraki çalışmalara ışık tutmaktır.
Gereç ve Yöntemler: 12 Mart 2017 ile 12 Mart 2023 tarihleri arasında Kayseri Şehir Hastanesi ne başvuran Spontan Pnömotoraks
tanısı alan hastalar retrospektif olarak medikal hastane kayıtları üzerinden tarandı. Hastalar yaş, cinsiyet, primer ve sekonder pnömotoraks olması, sigara içimi, vücut kitle indeksi (VKİ), uygulanan tedavi, hastanede kalış süresi, COVID-19 PCR pozitifliği, nüks
kriterleri üzerinden değerlendirildi. COVID-19 öncesi ve sonrası bu kriterler üzerinden karşılaştırıldı.
Bulgular: COVID-19 öncesi başvuran 160 hasta, COVID-19 sonrası başvuran 138 hasta tespit edildi. COVID-19 öncesi başvuran
hastaların 140’ı (%87) erkek, 20’si (%13) kadındı. COVID-19 sonrası başvuran 138 hastanın 124’ü (%89) erkek, 14’ü (%11) ise
kadındı. Hastaların yaş ortalamalarına bakıldığında COVID-19 öncesi yaş ortalaması 25, COVID-19 sonrası ise 28 idi. COVID-19
öncesi başvuran 160 hastanın 111’i (%69) primer spontan pnömotoraks, 49’u (%31) ise sekonder spontan pnömotoraks olarak
bulundu. COVID-19 sonrası ise 138 hastanın 108’i (%78) primer spontan pnömotoraks, 30’u (%22) sekonder spontan pnömotoraks idi.
Sonuç: Sonuç olarak COVID-19 akciğerlerde kronik inflamasyon ve fibrozisin yanı sıra bül ve bleb oluşumu nedeniyle de spontan
pnömotoraks riskini arttırmaktadır. COVID-19 ve spontan pnömotoraks patofizyolojisi net aydınlatılamamıştır. Bu çalışma bu alanda daha sonra yapılacak çalışmalara önayak olacaktır.
Keywords
Ethical Statement
Etik onay: Kayseri şehir hastanesi etik kurul kararı no:920/03.10.2023
Supporting Institution
Bu araştırma kamu, ticari veya kar amacı gütmeyen sektörlerdeki finansman kuruluşlarından herhangi bir özel hibe almamıştır.
Thanks
Hasta Onamı: Yazılı hasta onamı bu çalışmaya katılan hasta(lar)dan alınmıştır. Çıkar Çatışması: Yazar(lar) herhangi bir çıkar çatışması olmadığını beyan etmişlerdir. Finansman: Bu araştırma kamu, ticari veya kar amacı gütmeyen sektörlerdeki finansman kuruluşlarından herhangi bir özel hibe almamıştır. Açıklama: Yazarlar, bu makalede bahsedilen herhangi bir ürüne veya tartışılan konsepte ilişkin herhangi bir mülkiyet veya ticari çıkar açıklamamıştır. Etik onay: Kayseri şehir hastanesi etik kurul kararı no:920/03.10.2023
References
- 1. Sahn SA, Heffner JE. Spontaneous pneumothorax. New England Journal of Medicine. 2000;342(12):868-74.
- 2. Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax. 2000;55(8):666-71.
- 3. Olesen WH, Titlestad IL, Andersen PE, Lindahl-Jacobsen R, Licht PB. Incidence of primary spontaneous pneumothorax: a validated, register-based nationwide study. ERJ Open Res. 2019;5(2):00022-2019.
- 4. Bobbio A, Dechartres A, Bouam S, Damotte D, Rabbat A, Régnard JF, et al. Epidemiology of spontaneous pneumothorax: gender-related differences. Thorax. 2015;70(7):653-8.
- 5. Hallifax R. Aetiology of primary spontaneous pneumothorax. Journal of Clinical Medicine. 2022;11(3):490.
- 6. Bonilla A, Blair AJ, Alamro SM, Ward RA, Feldman MB, Dutko RA, et al. Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: A case report and review of the literature. Journal of Medical Case Reports. 2019;13(1):1-6.
- 7. Bense L, Eklund G, Wiman LG. Smoking and the increased risk of contracting spontaneous pneumothorax. Chest. 1987;92(6):1009-12.
- 8. Henry M, Arnold T, Harvey J. BTS guidelines for the management of spontaneous pneumothorax. Thorax. 2003;58(2):ii39.
- 9. Lipscomb VJ, Hardie RJ, Dubielzig RR. Spontaneous pneumothorax caused by pulmonary blebs and bullae in 12 dogs. Journal of the American Animal Hospital Association. 2003;39(5):435-45.
- 10. Sattler A. Zur behandlung des spontanpneumothorax mit besonderer berücksichtigung der thorakoskopie. Beiträge zur Klinik der Tuberkulose und spezifischen Tuberkulose-Forschung. 1937;89:395-408.
- 11. O’Rourke JP, Yee ES. Civilian spontaneous pneumothorax: treatment options and long-term results. Chest. 1989;96(6):1302-6.
- 12. Noppen M, Alexander P, Driesen P, Slabbynck H, Verstraeten A. Manual aspiration versus chest tube drainage in first episodes of primary spontaneous pneumothorax: a multicenter, prospective, randomized pilot study. American Journal of Respiratory and Critical Care Medicine. 2002;165(9):1240-4.
- 13. Margolis M, Gharagozloo F, Tempesta B, Trachiotis GD, Katz NM, Alexander EP. Video-assisted thoracic surgical treatment of initial spontaneous pneumothorax in young patients. The Annals of Thoracic Surgery. 2003;76(5):1661-4.
- 14. Almind M, Lange P, Viskum K. Spontaneous pneumothorax: comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis. Thorax. 1989;44(8):627-30.
- 15. Ciotti M, Ciccozzi M, Terrinoni A, Jiang W-C, Wang C-B, Bernardini S. The COVID-19 pandemic. Critical Reviews in Clinical Laboratory Sciences. 2020;57(6):365-88.
- 16. Madabhavi I, Sarkar M, Kadakol N. COVID-19: A review. Monaldi Archives for Chest Disease. 2020;90(2).
- 17. Lyu R, Li X. Diagnosis and treatment of severe COVID-19 complicated with spontaneous pneumothorax: A case report. Advanced Ultrasound in Diagnosis and Therapy. 2020;4(2):142-6.
- 18. Mittal A, Sabharwal S, Foley R. Bullous lung disease complicating COVID-19 pneumonia. Chest. 2021;160(4):A908.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Thoracic Surgery |
| Journal Section | Makale |
| Authors | |
| Publication Date | December 5, 2023 |
| Acceptance Date | November 13, 2023 |
| Published in Issue | Year 2023 Volume: 8 Issue: 4 |
