Pneumomediastinum and pneumothorax in coronavirus disease-2019: Description of a case series and a matched cohort study.

To describe the characteristics of COVID-19 patients with pneumothorax and pneumomediastinum (PTX/PM) and their association with patient outcomes. Adults admitted to five Mayo Clinic hospitals with COVID-19 between 03/2020-01/2022 were evaluated. PTX/PM was defined by imaging. Descriptive analyses and a matched (age, sex, admission month, COVID-19 severity) cohort comparison was performed. Hospital mortality, length of stay (LOS), and predisposing factors were assessed. Among 6663 patients, 197 had PTX/PM (3 %) (75 PM, 40 PTX, 82 both). The median age was 59, with 71 % males. Exposure to invasive and non-invasive mechanical ventilation and high-flow nasal cannula before PTX/PM were 42 %, 17 %, and 20 %, respectively. Among isolated PTX and PM/PTX patients 70 % and 53.7 % underwent an intervention, respectively, while 96 % of the PM-only group was followed conservatively.A total of 171 patients with PTX/PM were compared to 171 matched controls. PTX/PM patients had more underlying lung disease (40.9 In COVID-19 patients with similar severity, PTX/PM patients had more underlying lung disease and lower BMI. They had significantly increased mortality and LOS.

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Déclaration de conflit d'intérêts

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Rahul Kashyap reports financial support was provided by 10.13039/100000936Gordon and Betty Moore Foundation. Rahul Kashyap reports financial support was provided by 10.13039/100005205Janssen Research & Development LLC. Rahul Kashyap reports a relationship with National Heart Lung and Blood Institute that includes: funding grants. Rahul Kashyap reports a relationship with Ambient Clinical Analytics that includes: funding grants. Ognjen Gajic reports a relationship with Agency of Healthcare Research and Quality that includes: funding grants. Ognjen Gajic reports a relationship with National Heart Lung and Blood Institute that includes: funding grants. Ognjen Gajic reports a relationship with Ambient Clinical Analytics that includes: funding grants. Ognjen Gajic reports a relationship with 10.13039/100000005Department of Defense that includes: funding grants. Ognjen Gajic reports a relationship with 10.13039/100000968American Heart Association that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.