Citation Information :
Chakraborty S, Kumar R, Taneja A. Spontaneous Air-leak Syndrome and COVID-19: A Multifaceted Challenge. Indian J Crit Care Med 2021; 25 (5):584-587.
Spontaneous air-leak syndromes have emerged as rare but significant complication of Coronavirus disease-2019 (COVID-19) pneumonia in the last few months. This complication has been documented in both spontaneous and mechanically ventilated patients. Although few studies have used computed tomographic scans to confirm the diagnosis, this could be challenging in resource-limited setup. We present a series of 15 cases that highlight the clinical heterogeneity with respect to stage of illness, ventilatory status, and varied clinical scenarios at the time of development of these syndromes. All cases in our series were diagnosed clinically and confirmed by bedside chest X-ray and were managed promptly. Though mortality was not so infrequent in our experience, these air-leak syndromes were not directly attributed as cause of death in these patients. Therefore, high level of clinical suspicion and vigilance is necessary to identify and manage cases of air-leak syndrome.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507–513. DOI: 10.1016/S0140-6736(20)30211-7.
Yang F, Shi S, Zhu J, Shi J, Dai K, Chen X. Analysis of 92 deceased patients with COVID-19. J Med Virol 2020:10.1002/jmv.25891. DOI: 10.1002/jmv.25891.
Das KM, Lee EY, Al Jawder SE, Enani MA, Singh R, Skakni L, et al. Acute middle east respiratory syndrome coronavirus: temporal lung changes observed on the chest radiographs of 55 patients. Am J Roentgenol 2015;205(3):W267–W274. DOI: 10.2214/AJR.15.14445.
Berlin DA, Gulick RM, Martinez FJ. Severe covid-19. N Engl J Med 2020. DOI: 10.1056/NEJMcp2009575.
Jones E, Gould A, Pillay TD, Khorasanee R, Sykes R, Bazo-Alvarez JC, et al. Subcutaneous emphysema, pneumomediastinum, and pneumothorax in critically ill patients with coronavirus disease 2019: a retrospective cohort study. Crit Care Explor 2020;2(9):e0210. DOI: 10.1097/CCE.0000000000000210.
Mallick T, Dinesh A, Engdahl R, Sabado M. COVID-19 complicated by spontaneous pneumothorax. Cureus 2020;12(7):e9104. DOI: 10.7759/cureus.9104.
Do Lago VC, Cezare TJ, Fortaleza CMCB, Okoshi MP, Baldi BG, Tanni SE. Does COVID-19 increase the risk for spontaneous pneumothorax? Am J Med Sci 2020;S0002-9629(20)30320-7. DOI: 10.1016/j.amjms.2020.07.024.
Zantah M, Dominguez Castillo E, Townsend R, Dikengil F, Criner GJ. Pneumothorax in COVID-19 disease- incidence and clinical characteristics. Respir Res 2020;21(1):236. DOI: 10.1186/s12931-020-01504-y.
Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA 2020;323:2329–2330. DOI: 10.1001/jama.2020.6825.
Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 2017;195:438–442. DOI: 10.1164/rccm.201605-1081CP.
