Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.

Miró Ò; Llorens P; Jiménez S; Piñera P; Burillo-Putze G; Martín A; Martín-Sánchez FJ; García-Lamberetchs EJ; Jacob J; Alquézar-Arbé A; Mòdol JM; López-Díez MP; Guardiola JM; Cardozo C; Lucas Imbernón FJ; Aguirre Tejedo A; García García Á; Ruiz Grinspan M; Llopis Roca F; González Del Castillo J; Spanish Investigators on Emergency Situations Team (SIESTA) Network

Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.

BACKGROUND: Recent reports of patients with coronavirus disease 2019 (COVID-19) developing pneumothorax correspond mainly to case reports describing mechanically ventilated patients. The real incidence, clinical characteristics, and outcome of spontaneous pneumothorax (SP) as a form of COVID-19 pres...

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Autores:	Miró Ò, Llorens P, Jiménez S, Piñera P, Burillo-Putze G, Martín A, Martín-Sánchez FJ, García-Lamberetchs EJ, Jacob J, Alquézar-Arbé A, Mòdol JM, López-Díez MP, Guardiola JM, Cardozo C, Lucas Imbernón FJ, Aguirre Tejedo A, García García Á, Ruiz Grinspan M, Llopis Roca F, González Del Castillo J, Spanish Investigators on Emergency Situations Team (SIESTA) Network
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2021
País:	España
Institución:	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:	oai:isabial.fundanetsuite.com:p6826
Acceso en línea:	https://isabial.portalinvestigacion.com/publicaciones6826
Access Level:	acceso abierto
Palabra clave:	COVID-19 SARS-CoV-2 clinical characteristics incidence outcome risk factors spontaneous pneumothorax

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spelling	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.Miró ÒLlorens PJiménez SPiñera PBurillo-Putze GMartín AMartín-Sánchez FJGarcía-Lamberetchs EJJacob JAlquézar-Arbé AMòdol JMLópez-Díez MPGuardiola JMCardozo CLucas Imbernón FJAguirre Tejedo AGarcía García ÁRuiz Grinspan MLlopis Roca FGonzález Del Castillo JSpanish Investigators on Emergency Situations Team (SIESTA) NetworkCOVID-19SARS-CoV-2clinical characteristicsincidenceoutcomerisk factorsspontaneous pneumothoraxBACKGROUND: Recent reports of patients with coronavirus disease 2019 (COVID-19) developing pneumothorax correspond mainly to case reports describing mechanically ventilated patients. The real incidence, clinical characteristics, and outcome of spontaneous pneumothorax (SP) as a form of COVID-19 presentation remain to be defined. RESEARCH QUESTION: Do the incidence, risk factors, clinical characteristics, and outcomes of SP in patients with COVID-19 attending EDs differ compared with COVID-19 patients without SP and non-COVID-19 patients with SP? STUDY DESIGN AND METHODS: This case-control study retrospectively reviewed all patients with COVID-19 diagnosed with SP (case group) in 61 Spanish EDs (20% of Spanish EDs) and compared them with two control groups: COVID-19 patients without SP and non-COVID-19 patients with SP. The relative frequencies of SP were estimated in COVID-19 and non-COVID-19 patients in the ED, and annual standardized incidences were estimated for both populations. Comparisons between case subjects and control subjects included 52 clinical, analytical, and radiologic characteristics and four outcomes. RESULTS: We identified 40 occurrences of SP in 71,904 patients with COVID-19 attending EDs (0.56‰; 95% CI, 0.40‰-0.76‰). This relative frequency was higher than that among non-COVID-19 patients (387 of 1,358,134, 0.28‰; 95% CI, 0.26‰-0.32‰; OR, 1.93; 95% CI, 1.41-2.71). The standardized incidence of SP was also higher in patients with COVID-19 (34.2 vs 8.2/100,000/year; OR, 4.19; 95% CI, 3.64-4.81). Compared with COVID-19 patients without SP, COVID-19 patients developing SP more frequently had dyspnea and chest pain, low pulse oximetry readings, tachypnea, and increased leukocyte count. Compared with non-COVID-19 patients with SP, case subjects differed in 19 clinical variables, the most prominent being a higher frequency of dysgeusia/anosmia, headache, diarrhea, fever, and lymphopenia (all with OR > 10). All the outcomes measured, including in-hospital death, were worse in case subjects than in both control groups. INTERPRETATION: SP as a form of COVID-19 presentation at the ED is unusual (< 1‰ cases) but is more frequent than in the non-COVID-19 population and could be associated with worse outcomes than SP in non-COVID-19 patients and COVID-19 patients without SP.ELSEVIER2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones6826CHESTISSN: 00123692ISSNe: 19313543reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p68262026-06-12T10:20:37Z
dc.title.none.fl_str_mv	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
title	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
spellingShingle	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study. Miró Ò COVID-19 SARS-CoV-2 clinical characteristics incidence outcome risk factors spontaneous pneumothorax
title_short	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
title_full	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
title_fullStr	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
title_full_unstemmed	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
title_sort	Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
dc.creator.none.fl_str_mv	Miró Ò Llorens P Jiménez S Piñera P Burillo-Putze G Martín A Martín-Sánchez FJ García-Lamberetchs EJ Jacob J Alquézar-Arbé A Mòdol JM López-Díez MP Guardiola JM Cardozo C Lucas Imbernón FJ Aguirre Tejedo A García García Á Ruiz Grinspan M Llopis Roca F González Del Castillo J Spanish Investigators on Emergency Situations Team (SIESTA) Network
author	Miró Ò
author_facet	Miró Ò Llorens P Jiménez S Piñera P Burillo-Putze G Martín A Martín-Sánchez FJ García-Lamberetchs EJ Jacob J Alquézar-Arbé A Mòdol JM López-Díez MP Guardiola JM Cardozo C Lucas Imbernón FJ Aguirre Tejedo A García García Á Ruiz Grinspan M Llopis Roca F González Del Castillo J Spanish Investigators on Emergency Situations Team (SIESTA) Network
author_role	author
author2	Llorens P Jiménez S Piñera P Burillo-Putze G Martín A Martín-Sánchez FJ García-Lamberetchs EJ Jacob J Alquézar-Arbé A Mòdol JM López-Díez MP Guardiola JM Cardozo C Lucas Imbernón FJ Aguirre Tejedo A García García Á Ruiz Grinspan M Llopis Roca F González Del Castillo J Spanish Investigators on Emergency Situations Team (SIESTA) Network
author2_role	author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	COVID-19 SARS-CoV-2 clinical characteristics incidence outcome risk factors spontaneous pneumothorax
topic	COVID-19 SARS-CoV-2 clinical characteristics incidence outcome risk factors spontaneous pneumothorax
description	BACKGROUND: Recent reports of patients with coronavirus disease 2019 (COVID-19) developing pneumothorax correspond mainly to case reports describing mechanically ventilated patients. The real incidence, clinical characteristics, and outcome of spontaneous pneumothorax (SP) as a form of COVID-19 presentation remain to be defined. RESEARCH QUESTION: Do the incidence, risk factors, clinical characteristics, and outcomes of SP in patients with COVID-19 attending EDs differ compared with COVID-19 patients without SP and non-COVID-19 patients with SP? STUDY DESIGN AND METHODS: This case-control study retrospectively reviewed all patients with COVID-19 diagnosed with SP (case group) in 61 Spanish EDs (20% of Spanish EDs) and compared them with two control groups: COVID-19 patients without SP and non-COVID-19 patients with SP. The relative frequencies of SP were estimated in COVID-19 and non-COVID-19 patients in the ED, and annual standardized incidences were estimated for both populations. Comparisons between case subjects and control subjects included 52 clinical, analytical, and radiologic characteristics and four outcomes. RESULTS: We identified 40 occurrences of SP in 71,904 patients with COVID-19 attending EDs (0.56‰; 95% CI, 0.40‰-0.76‰). This relative frequency was higher than that among non-COVID-19 patients (387 of 1,358,134, 0.28‰; 95% CI, 0.26‰-0.32‰; OR, 1.93; 95% CI, 1.41-2.71). The standardized incidence of SP was also higher in patients with COVID-19 (34.2 vs 8.2/100,000/year; OR, 4.19; 95% CI, 3.64-4.81). Compared with COVID-19 patients without SP, COVID-19 patients developing SP more frequently had dyspnea and chest pain, low pulse oximetry readings, tachypnea, and increased leukocyte count. Compared with non-COVID-19 patients with SP, case subjects differed in 19 clinical variables, the most prominent being a higher frequency of dysgeusia/anosmia, headache, diarrhea, fever, and lymphopenia (all with OR > 10). All the outcomes measured, including in-hospital death, were worse in case subjects than in both control groups. INTERPRETATION: SP as a form of COVID-19 presentation at the ED is unusual (< 1‰ cases) but is more frequent than in the non-COVID-19 population and could be associated with worse outcomes than SP in non-COVID-19 patients and COVID-19 patients without SP.
publishDate	2021
dc.date.none.fl_str_mv	2021
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://isabial.portalinvestigacion.com/publicaciones6826
url	https://isabial.portalinvestigacion.com/publicaciones6826
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	ELSEVIER
publisher.none.fl_str_mv	ELSEVIER
dc.source.none.fl_str_mv	CHEST ISSN: 00123692 ISSNe: 19313543 reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
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Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.

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