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- Title
Risk factors of pneumothorax and pneumomediastinum in COVID-19: a matched case–control study.
- Authors
Lee, Se Ju; Kim, Jinnam; Lee, Ki Hyun; Lee, Jung Ah; Kim, Chang Hyup; Lee, Su Hwan; Park, Byung Jo; Kim, Jung Ho; Ahn, Jin Young; Jeong, Su Jin; Ku, Nam Su; Yeom, Joon-Sup; Choi, Jun Yong
- Abstract
Background: During the novel coronavirus disease-2019 pandemic, a considerable number of pneumothorax (PNX)/pneumomediastinum (PNM) associated with COVID-19 have been reported, and the incidence is higher in critically ill patients. Despite using a protective ventilation strategy, PNX/PNM still occurs in patients on invasive mechanical ventilation (IMV). This matched case–control study aims to identify the risk factors and clinical characteristics of PNX/PNM in COVID-19. Methods: This retrospective study enrolled adult patients with COVID-19, admitted to a critical care unit from March 1, 2020, to January 31, 2022. COVID-19 patients with PNX/PNM were compared, in a 1–2 ratio, to COVID-19 patients without PNX/PNM, matched for age, gender, and worst National Institute of Allergy and Infectious Diseases ordinal scale. Conditional logistic regression analysis was performed to assess the risk factors for PNX/PNM in COVID-19. Results: 427 patients with COVID-19 were admitted during the period, and 24 patients were diagnosed with PNX/PNM. Body mass index (BMI) was significantly lower in the case group (22.8 kg/m2 and 24.7 kg/m2; P = 0.048). BMI was statistically significant risk factor for PNX/PNM in univariate conditional logistic regression analysis [odds ratio (OR), 0.85; confidence interval (CI), 0.72–0.996; P = 0.044]. For patients on IMV support, univariate conditional logistic regression analysis showed the statistical significance of the duration from symptom onset to intubation (OR, 1.14; CI, 1.006–1.293; P = 0.041). Conclusions: Higher BMI tended to show a protective effect against PNX/PNM due to COVID-19 and delayed application of IMV might be a contributive factor for this complication.
- Subjects
NATIONAL Institute of Allergy &; Infectious Diseases (U.S.); PNEUMOTHORAX; COVID-19; INTENSIVE care units; LOGISTIC regression analysis; SARS-CoV-2; PNEUMOMEDIASTINUM
- Publication
BMC Infectious Diseases, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2334
- Publication type
Article
- DOI
10.1186/s12879-023-08104-3