Pneumothorax in Patients with Moderate to Severe Covid-19 Infection:A Retrospective Observational Study

  • Rahul George Assistant Professor, Department of General Surgery, M.O.S.C Medical College & Hospital, Kolenchery, Ernakulam, Kerala,India
  • Vijy Paul Thomas Unit Chief and H.O.D, Department of General Surgery, M.O. S.C Medical College & Hospital, Kolenchery, Ernakulam,Kerala, India
  • Shalini Miriam Ipe ssociate Professor, Department of Anesthesiology, M.O.S.C Medical College & Hospital, Kolenchery, Ernakulam,Kerala, India
  • Joicy Els Jojo Junior Resident, Department of General Surgery, M.O.S.C Medical College & Hospital, Kolenchery, Ernakulam, Kerala,India
Keywords: COVID-19,Pneumomediastinum, Pneumonia , Pneumothorax, Ventilation


Background: Spontaneous pneumothorax as a complication of COVID-19 pneumonia is eitheruncommon or under-reported. The exact incidence and risk factors are still unknown. The objectiveof this study is to highlight an important complication, its incidence and explore the predisposing riskfactors.

Methods: We performed a retrospective review of COVID-19 pneumonia cases admitted toour hospital between February 2021 and June 2021. Data on their demographics, pre-existing riskfactors, laboratory workup, imaging, treatment and clinical outcomes were gathered.

Results: Onethousand eight hundred and twenty-five patients have admitted to our institution between February2021 and June 2021 with COVID-19 infection. 11 patients developed a pneumothorax (0.6%). 6 outof the 11 cases were patients who required mechanical ventilation (54.5%). All of these patientsunderwent chest tube insertion. Baseline imaging of these patients showed ground-glass opacities(GGO) and consolidation. 8 of the 11 patients succumbed to the disease (72.7%).

Conclusion: Inpatients admitted with COVID-19 pneumonia and developing sudden respiratory compromise,pneumothorax is an important complication to be considered. Prompt identification of thiscomplication and timely intervention is necessary to reduce morbidity and mortality. Low tidalvolume lung-protective ventilation and the use of non-invasive ventilation for oxygenation remainthe cornerstone in the management of COVID pneumonia. It significantly decreases iatrogeniccomplications like VILI (ventilator-induced lung injury) and P-SILI (patient self-inflicted lung injury.


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How to Cite
Rahul George, Vijy Paul Thomas, Shalini Miriam Ipe, & Joicy Els Jojo. (2022). Pneumothorax in Patients with Moderate to Severe Covid-19 Infection:A Retrospective Observational Study. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 8(1), 12-23. Retrieved from
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