Aleksandra Murawska Baptista, Jorge Sinclair De Frías, Trisha Singh, Ananya Vasudhar, Jacob Guzzino, Waheed Khalili, Aysun Tekin, Vikas Bansal, Rahul Kashyap, William J Joyce, Patricia A Lewis, Devang Sanghavi, Tatjana Gavrancic, Pablo Moreno Franco
{"title":"新冠肺炎住院患者的胸腔、纵隔气肿和皮下气肿:发病率、临床特征和结果。","authors":"Aleksandra Murawska Baptista, Jorge Sinclair De Frías, Trisha Singh, Ananya Vasudhar, Jacob Guzzino, Waheed Khalili, Aysun Tekin, Vikas Bansal, Rahul Kashyap, William J Joyce, Patricia A Lewis, Devang Sanghavi, Tatjana Gavrancic, Pablo Moreno Franco","doi":"10.1080/17476348.2023.2254689","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Limited data is available on the incidence and outcomes of pneumothorax (PTX), pneumomediastinum (PNM), and subcutaneous emphysema (SCE) in COVID-19 patients. This study aimed to investigate the characteristics of these complications in hospitalized COVID-19 patients.</p><p><strong>Research design and methods: </strong>A retrospective study was conducted, involving adult COVID-19 patients admitted to Mayo Clinic Florida from 03/2020-06/2022. Patients were divided into two groups based on the presence or absence of PTX/PNM/SCE.</p><p><strong>Results: </strong>1926 hospitalized patients with COVID-19 were included, of which 518 were admitted to the ICU. The incidence of PTX/PNM/SCE was 6.3%. Patients with these complications were more likely to be male, Asian, and unvaccinated. Conversely, they were less likely to have chronic obstructive pulmonary disease. Patients who developed PTX/PNM/SCE after 72 hours of admission were more likely to receive high-dose corticosteroids and for an extended duration. The affected group had an adjusted odds ratio for in-hospital mortality of 13.32 (95%CI, 8.19-21.59) and ICU admission of 9.14 (95%CI, 5.3-12.78) compared to the unaffected group.</p><p><strong>Conclusion: </strong>Although the occurrence of PTX/PNM/SCE in hospitalized COVID-19 patients was rare, it was associated with worse outcomes. Corticosteroids may contribute to the pathogenesis of these complications; however, further studies are needed to investigate this relationship in more detail.</p>","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pneumothorax, pneumomediastinum, and subcutaneous emphysema in hospitalized COVID-19 patients: incidence, clinical characteristics, and outcomes.\",\"authors\":\"Aleksandra Murawska Baptista, Jorge Sinclair De Frías, Trisha Singh, Ananya Vasudhar, Jacob Guzzino, Waheed Khalili, Aysun Tekin, Vikas Bansal, Rahul Kashyap, William J Joyce, Patricia A Lewis, Devang Sanghavi, Tatjana Gavrancic, Pablo Moreno Franco\",\"doi\":\"10.1080/17476348.2023.2254689\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Limited data is available on the incidence and outcomes of pneumothorax (PTX), pneumomediastinum (PNM), and subcutaneous emphysema (SCE) in COVID-19 patients. This study aimed to investigate the characteristics of these complications in hospitalized COVID-19 patients.</p><p><strong>Research design and methods: </strong>A retrospective study was conducted, involving adult COVID-19 patients admitted to Mayo Clinic Florida from 03/2020-06/2022. Patients were divided into two groups based on the presence or absence of PTX/PNM/SCE.</p><p><strong>Results: </strong>1926 hospitalized patients with COVID-19 were included, of which 518 were admitted to the ICU. The incidence of PTX/PNM/SCE was 6.3%. Patients with these complications were more likely to be male, Asian, and unvaccinated. Conversely, they were less likely to have chronic obstructive pulmonary disease. Patients who developed PTX/PNM/SCE after 72 hours of admission were more likely to receive high-dose corticosteroids and for an extended duration. The affected group had an adjusted odds ratio for in-hospital mortality of 13.32 (95%CI, 8.19-21.59) and ICU admission of 9.14 (95%CI, 5.3-12.78) compared to the unaffected group.</p><p><strong>Conclusion: </strong>Although the occurrence of PTX/PNM/SCE in hospitalized COVID-19 patients was rare, it was associated with worse outcomes. Corticosteroids may contribute to the pathogenesis of these complications; however, further studies are needed to investigate this relationship in more detail.</p>\",\"PeriodicalId\":12103,\"journal\":{\"name\":\"Expert Review of Respiratory Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Respiratory Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/17476348.2023.2254689\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Respiratory Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17476348.2023.2254689","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Pneumothorax, pneumomediastinum, and subcutaneous emphysema in hospitalized COVID-19 patients: incidence, clinical characteristics, and outcomes.
Background: Limited data is available on the incidence and outcomes of pneumothorax (PTX), pneumomediastinum (PNM), and subcutaneous emphysema (SCE) in COVID-19 patients. This study aimed to investigate the characteristics of these complications in hospitalized COVID-19 patients.
Research design and methods: A retrospective study was conducted, involving adult COVID-19 patients admitted to Mayo Clinic Florida from 03/2020-06/2022. Patients were divided into two groups based on the presence or absence of PTX/PNM/SCE.
Results: 1926 hospitalized patients with COVID-19 were included, of which 518 were admitted to the ICU. The incidence of PTX/PNM/SCE was 6.3%. Patients with these complications were more likely to be male, Asian, and unvaccinated. Conversely, they were less likely to have chronic obstructive pulmonary disease. Patients who developed PTX/PNM/SCE after 72 hours of admission were more likely to receive high-dose corticosteroids and for an extended duration. The affected group had an adjusted odds ratio for in-hospital mortality of 13.32 (95%CI, 8.19-21.59) and ICU admission of 9.14 (95%CI, 5.3-12.78) compared to the unaffected group.
Conclusion: Although the occurrence of PTX/PNM/SCE in hospitalized COVID-19 patients was rare, it was associated with worse outcomes. Corticosteroids may contribute to the pathogenesis of these complications; however, further studies are needed to investigate this relationship in more detail.
期刊介绍:
Coverage will include the following key areas:
- Prospects for new and emerging therapeutics
- Epidemiology of disease
- Preventive strategies
- All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities
- Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests.
- Advances in the treatment of respiratory infections and drug resistance issues
- Occupational and environmental factors
- Progress in smoking intervention and cessation methods
- Disease and treatment issues for defined populations, such as children and the elderly
- Respiratory intensive and critical care
- Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity