Pneumothorax is an important complication of coronavirus disease 2019 (COVID-19) [1, 2]. Based on a series of 60 individuals, we previously estimated that 0.91% of people admitted to hospital with COVID-19 develop pneumothorax [1]. Males accounted for three quarters of those affected, and patients requiring noninvasive or invasive ventilatory support appeared at elevated risk. In a separate series of ventilated patients with COVID-19, barotrauma, defined as pneumothorax or pneumomediastinum, was found to be an independent risk for death [2]. During the pandemic, treatment strategies have evolved, influenced by large randomised controlled trials and clinical experience. Following the landmark results from the RECOVERY trial [3], dexamethasone became standard of care for patients requiring supplemental oxygen. Following the first UK wave between March and June 2020, use of noninvasive respiratory support became more common [4, 5]. Such changes could plausibly alter the incidence of pneumothorax caused by COVID-19. Indeed, a recent small study reported an increase in pneumothoraces in the second wave of COVID-19 in Italy, leading to speculation that dexamethasone use might have been causal [6]. Population level data from 131 679 patients show that COVID-19 pneumothorax occurs in 0.97% of admitted patients, especially males and smokers, and is associated with increased mortality https://bit.ly/3oB27ez
【초록키워드】 COVID-19, Dexamethasone, coronavirus disease, randomised controlled trial, pandemic, hospital, risk, Italy, Population, male, Patient, death, second wave, Pneumothorax, incidence, change, patients, RECOVERY trial, Smokers, treatment strategy, noninvasive, Pneumomediastinum, ventilatory support, Support, Standard of care, increased mortality, clinical experience, Alter, invasive, independent, defined, affected, develop, caused, reported, elevated, accounted, occur, increase in, individuals, noninvasive respiratory, pneumothorace, requiring supplemental oxygen, ventilated patient, with COVID-19, 【제목키워드】 COVID-19, protocol, prospective observational study, WHO, characterisation, ISARIC,