سامانه مدیریت نشریات علمی دانشگاه علوم پزشکی مشهد

Fazlıoğlu, Mithat, Fazlıoğlu, Nevin, Akpunar, Esranur, Ergönül, Ayşe. (1404). Spontaneous Air Leak Syndromes in COVID-19: A Retrospective Analysis of 124 Patients. , 13(2), 1522-1528. doi: 10.22038/jctm.2025.88546.1491
Mithat Fazlıoğlu; Nevin Fazlıoğlu; Esranur Akpunar; Ayşe Gül Ergönül. "Spontaneous Air Leak Syndromes in COVID-19: A Retrospective Analysis of 124 Patients". , 13, 2, 1404, 1522-1528. doi: 10.22038/jctm.2025.88546.1491
Fazlıoğlu, Mithat, Fazlıoğlu, Nevin, Akpunar, Esranur, Ergönül, Ayşe. (1404). 'Spontaneous Air Leak Syndromes in COVID-19: A Retrospective Analysis of 124 Patients', , 13(2), pp. 1522-1528. doi: 10.22038/jctm.2025.88546.1491
Fazlıoğlu, Mithat, Fazlıoğlu, Nevin, Akpunar, Esranur, Ergönül, Ayşe. Spontaneous Air Leak Syndromes in COVID-19: A Retrospective Analysis of 124 Patients. , 1404; 13(2): 1522-1528. doi: 10.22038/jctm.2025.88546.1491

Spontaneous Air Leak Syndromes in COVID-19: A Retrospective Analysis of 124 Patients

Journal of Cardio-Thoracic Medicine
مقاله 3، دوره 13، شماره 2، شهریور 2025، صفحه 1522-1528    اصل مقاله (1.3 M)
نوع مقاله: Original Article
شناسه دیجیتال (DOI): 10.22038/jctm.2025.88546.1491
نویسندگان
Mithat Fazlıoğlu* 1؛ Nevin Fazlıoğlu2؛ Esranur Akpunar3؛ Ayşe Gül Ergönül3
1Department of Thoracic Surgery, Tekirdag Namik Kemal University Faculty of Medicine, Tekirdag, Turkey.
2Department of Pulmonology, Tekirdag Namik Kemal University Faculty of Medicine, Tekirdag, Turkey.
3Department of Thoracic Surgery, Ege University Faculty of Medicine, Izmir, Turkey.
چکیده
Introduction: Air leak syndromes, including pneumothorax and pneumomediastinum, have emerged as important complications in patients with COVID-19, often occurring even in the absence of invasive respiratory support. This study aims to characterize the clinical features, severity, and outcomes of COVID-19 patients who developed spontaneous air leaks during their illness.
Methods: In this retrospective cohort study, 124 laboratory-confirmed COVID-19 patients who developed spontaneous pneumothorax and/or pneumomediastinum between March 20, 2020, and December 31, 2022, were evaluated. Demographics, comorbidities, smoking status, clinical severity, air leak characteristics, interventions, and outcomes were recorded and analyzed using descriptive and comparative statistics.
Results: The median age was 65.5 years, with 70.96% being male. Pneumothorax occurred in 87.10% of patients,  pneumomediastinum in 16.12%, and 3.22% had both conditions. None of the patients were on ventilatory support when the air leak occurred. The median time from COVID-19 diagnosis to air leak development was seven days. High-grade (Grade 3–4) air leaks were identified in 70.2% of cases and were significantly more common in patients with severe or critical COVID-19 (p = 0.002). Active smokers had higher rates of severe air leakage compared to non-smokers (81.0% vs. 56.1%, p = 0.011). Mechanical ventilation was subsequently required in 95.16% of patients. Tube thoracostomy was performed in 82.25% of cases, and the in-hospital mortality was 8.06%.
Conclusions: Spontaneous air leak syndromes may occur early in the COVID-19 disease course and are associated with greater clinical severity and smoking status. These findings challenge the traditional view of barotrauma-related air leaks and suggest that underlying alveolar fragility plays a key role. Further prospective studies are needed to refine early recognition and management strategies in this high-risk population.
کلیدواژه‌ها
Air leak syndromes؛ COVID-19؛ Pneumothorax؛ Pneumomediastinum؛ Respiratory complications؛ Spontaneous
مراجع
  1. Li H, Liu Z, Ge J. Scientific research progress of COVID‐19/SARS‐CoV‐2 in the first five months. Journal of cellular and molecular medicine. 2020 Jun;24(12):6558-70.
  2. Sohrabi C, Alsafi Z, O'neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International journal of surgery. 2020 Apr 1;76:71-6.
  3. Brito J, Gregório P, Mariani A, D’ambrosio P, Filho M, Ferreira L, et al. Pneumomediastinum in COVID-19 disease: outcomes and relation to the Macklin effect. Asian Cardiovascular and Thoracic Annals. 2021 Jul;29(6):541-8.
  4. Papagiannis A, Lazaridis G, Zarogoulidis K, Papaiwannou A, Karavergou A, Lampaki S, et al. Pneumothorax: an up to date “introduction”. Annals of translational medicine. 2015 Mar;3(4):53.
  5. Noppen M, De Keukeleire T. Pneumothorax. Respiration. 2008 Feb 1;76(2):121-7.
  6. Kouritas VK, Papagiannopoulos K, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Pneumomediastinum. J Thorac Dis. 2015; 7 (Suppl 1): S44-S49 [Internet].
  7. Ferguson ND, Frutos-Vivar F, Esteban A, Anzueto A, Alía I, Brower RG, et al. Airway pressures, tidal volumes, and mortality in patients with acute respiratory distress syndrome. Critical care medicine. 2005 Jan 1;33(1):21-30.
  8. De Latorre FJ, Klamburg J, Leon C, Soler M, Rius J. Incidence of pneumothorax and pneumomediastinum in patients with aspiration pneumonia requiring ventilatory support. Chest. 1977 Aug 1;72(2):141-4.
  9. Chong WH, Saha BK, Hu K, Chopra A. The incidence, clinical characteristics, and outcomes of pneumothorax in hospitalized COVID-19 patients: a systematic review. Heart & Lung. 2021 Sep 1;50(5):599-608.
  10. Chopra A, Al-Tarbsheh AH, Shah NJ, Yaqoob H, Hu K, Feustel PJ, et al. Pneumothorax in critically ill patients with COVID-19 infection: incidence, clinical characteristics and outcomes in a case control multicenter study. Respiratory medicine. 2021 Aug 1;184:106464.
  11. Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. European Respiratory Review. 2010 Sep;19(117):217.
  12. Kecskes G, Szabo A, Sutori D, Maroti P, Marovics G, Molnar TF. Pneumothorax/pneumomediastinum and pre-existing lung pathology in ventilated COVID-19 patients: a cohort study. Journal of Thoracic Disease. 2022 Dec;14(12):4733.
  13. Lee SJ, Kim J, Lee KH, Lee JA, Kim CH, Lee SH, et al. Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case–control study. BMC Infectious Diseases. 2023 Mar 7;23(1):137.
  14. Büyükkarabacak Y, Pirzirenli MG, Gurz S, Abacı H, Şengül AT, Çelik B, et al. COVID-19 and pneumothorax, pneumomediastinum, subcutaneous emphysema: Analysis of risk factors. Turkish Journal of Thoracic and Cardiovascular Surgery. 2023 Jan 30;31(1):69.
  15. Polatoğlu I, Oncu‐Oner T, Dalman I, Ozdogan S. COVID‐19 in early 2023: Structure, replication mechanism, variants of SARS‐CoV‐2, diagnostic tests, and vaccine & drug development studies. MedComm. 2023 Apr;4(2):e228.
  16. Yang F, Shi S, Zhu J, Shi J, Dai K, Chen X. Analysis of 92 deceased patients with COVID‐19. Journal of medical virology. 2020 Nov;92(11):2511-5.
  17. Nistor CE, Gavan CS, Pantile D, Tãnase NV, Ciuche A. Cervico-Thoracic Air Collections in COVID-19 Pneumonia Patients—Our Experience and Brief Review. Chirurgia. 2022 Jun;117:317-27.
  18. Belletti A, Palumbo D, Zangrillo A, Fominskiy EV, Franchini S, Dell'Acqua A, et al. Predictors of pneumothorax/pneumomediastinum in mechanically ventilated COVID-19 patients. Journal of cardiothoracic and vascular anesthesia. 2021 Dec 1;35(12):3642-51.
  19. Martinelli AW, Ingle T, Newman J, Nadeem I, Jackson K, Lane ND, et al. COVID-19 and pneumothorax: a multicentre retrospective case series. European Respiratory Journal. 2020 Nov 19;56(5).
  20. Elhakim TS, Abdul HS, Romero CP, Rodriguez-Fuentes Y. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review. BMJ Case Reports CP. 2020 Dec 1;13(12):e239489.
  21. Ceylan KC, Batihan G, Yazgan S, Gürsoy S, Kıraklı SC, Ataman S. Pleural complications in patients with coronavirus disease 2019 (COVID-19): how to safely apply and follow-up with a chest tube during the pandemic?. European Journal of Cardio-Thoracic Surgery. 2020 Dec;58(6):1216-21.
آمار
تعداد مشاهده مقاله: 90
تعداد دریافت فایل اصل مقاله: 28