Pneumothorax and Pneumomediastinum in Patients Admitted to Intensive Care Unit with COVID-19 Pneumonia: A Single Center Retrospective Analysis

Objectives: This study aimed to examine the frequency, and clinical features of pneumothorax and pneumomediastinum cases in patients admitted to the intensive care unit due to coronavirus disease-19 (CO-VID-19) pneumonia. Methods: We retrospectively screened the COVID-19 cases hospitalized in our intensive care unit between March 11, 2020, and January 11, 2022. Patients diagnosed as pneumothorax or pneumomediastinum were determined. The frequency and clinical features of pneumothorax and pneumomediastinum were investigated. Results: Seven hundred and twenty patients hospitalized in our intensive care unit between March 11, 2020, and January 11, 2022 were screened. Twenty-four (3.3%) patients had pneumothorax or pneumomediastinum. Pneumothorax occurred 17 patients (70%), and pneumomediastinum in 14 patients (58%). The number of patients who developed pneumomediastinum and pneumothorax together was 7 (29%). COVID-19-associated pneumothorax tended to be unilateral (n=16) and right-sided (n=11). In 18 (75%) patients, pneumothorax or pneumomediastinum developed during invasive mechanical ventilation, 5 (20.8%) patients during non-invasive mechanical ventilation. One patient developed pneumothorax when mechanical ventilation was not applied. The mortality rate at 60 days was 75% (n=18) in patients who were admitted to the intensive care unit with CO-VID-19 and developed pneumomediastinum or pneumothorax. Conclusion: Pneumothorax and pneumomediastinum are complications of COVID-19 pneumonia with high mortality rates.