tetano
Editor, Senior Moderator
Interdiscip Cardiovasc Thorac Surg
. 2025 Mar 26:ivaf076.
doi: 10.1093/icvts/ivaf076. Online ahead of print. COVID-19 patients with spontaneous pneumothorax: a propensity-matched, multicentre case-control study
Arianna Farronato[SUP] 1 [/SUP], Chiara Travaglia[SUP] 2 [/SUP], Alice Ravasin[SUP] 1 [/SUP], Vittorio Aprile[SUP] 3 [/SUP], Roberto Corzani[SUP] 4 [/SUP], Elisa Sicolo[SUP] 3 [/SUP], Adriano Peris[SUP] 5 [/SUP], Stefano Romagnoli[SUP] 2 [/SUP], Marco Lucchi[SUP] 3 [/SUP], Piero Paladini[SUP] 4 [/SUP], Luca Voltolini[SUP] 1 [/SUP], Alessandro Gonfiotti[SUP] 1 [/SUP]
Affiliations
Objectives: Pneumothorax and pneumomediastinum have been frequently reported in Coronavirus Disease-19 (COVID-19) thus complicating the patient's overall healthcare management and survival rate. The study aimed to evaluate the outcomes of COVID-19 patients, who developed spontaneous pneumothorax or spontaneous pneumomediastinum.
Methods: In this Italian multicentre retrospective cohort study, medical records in non-vaccinated COVID-19 patients, from March 2020 to May 2021, were analyzed. To reduce the risk of bias due to unbalanced groups, a Propensity Score Matching (PSM) approach was applied using logistic regression to estimate propensity scores. Separate multivariable Generalized Linear Models (GLMs) were then used to assess the risk of in-hospital mortality and other outcomes.
Results: 474 patients were assessed, of which 72 patients developed spontaneous pneumothorax or pneumomediastinum. In separate multivariable GLM regression analysis of un-matched cohort spontaneous pneumothorax (OR 2.44, 95% CI 1.7-5.55; p = 0.031) are associated with increase of in-hospital mortality rate, results confirmed even after matching the two cohorts. Spontaneous pneumomediastinum (OR 1.21, 95% CI 1.13-1.30, p < 0.001) and spontaneous pneumothorax (OR 1.34, 95% CI 1.26-1.43, p < 0.001) are associated with increase of length of stay. The risk of in-hospital mortality also increases with age, comorbidities (classified by Charlson comorbidity index), and smoking habits.
Conclusions: Spontaneous pneumothorax in hospitalized COVID-19 patients may be associated with an increased risk of in-hospital mortality and prolonged hospitalization.
Keywords: ARDS; COVID-19; Coronavirus; SARS Cov-2; Spontaneous Pneumomediastinum; Spontaneous Pneumothorax.
. 2025 Mar 26:ivaf076.
doi: 10.1093/icvts/ivaf076. Online ahead of print. COVID-19 patients with spontaneous pneumothorax: a propensity-matched, multicentre case-control study
Arianna Farronato[SUP] 1 [/SUP], Chiara Travaglia[SUP] 2 [/SUP], Alice Ravasin[SUP] 1 [/SUP], Vittorio Aprile[SUP] 3 [/SUP], Roberto Corzani[SUP] 4 [/SUP], Elisa Sicolo[SUP] 3 [/SUP], Adriano Peris[SUP] 5 [/SUP], Stefano Romagnoli[SUP] 2 [/SUP], Marco Lucchi[SUP] 3 [/SUP], Piero Paladini[SUP] 4 [/SUP], Luca Voltolini[SUP] 1 [/SUP], Alessandro Gonfiotti[SUP] 1 [/SUP]
Affiliations
- PMID: 40139717
- DOI: 10.1093/icvts/ivaf076
Objectives: Pneumothorax and pneumomediastinum have been frequently reported in Coronavirus Disease-19 (COVID-19) thus complicating the patient's overall healthcare management and survival rate. The study aimed to evaluate the outcomes of COVID-19 patients, who developed spontaneous pneumothorax or spontaneous pneumomediastinum.
Methods: In this Italian multicentre retrospective cohort study, medical records in non-vaccinated COVID-19 patients, from March 2020 to May 2021, were analyzed. To reduce the risk of bias due to unbalanced groups, a Propensity Score Matching (PSM) approach was applied using logistic regression to estimate propensity scores. Separate multivariable Generalized Linear Models (GLMs) were then used to assess the risk of in-hospital mortality and other outcomes.
Results: 474 patients were assessed, of which 72 patients developed spontaneous pneumothorax or pneumomediastinum. In separate multivariable GLM regression analysis of un-matched cohort spontaneous pneumothorax (OR 2.44, 95% CI 1.7-5.55; p = 0.031) are associated with increase of in-hospital mortality rate, results confirmed even after matching the two cohorts. Spontaneous pneumomediastinum (OR 1.21, 95% CI 1.13-1.30, p < 0.001) and spontaneous pneumothorax (OR 1.34, 95% CI 1.26-1.43, p < 0.001) are associated with increase of length of stay. The risk of in-hospital mortality also increases with age, comorbidities (classified by Charlson comorbidity index), and smoking habits.
Conclusions: Spontaneous pneumothorax in hospitalized COVID-19 patients may be associated with an increased risk of in-hospital mortality and prolonged hospitalization.
Keywords: ARDS; COVID-19; Coronavirus; SARS Cov-2; Spontaneous Pneumomediastinum; Spontaneous Pneumothorax.