Rev Med UAS
Vol. 11: No. 3. Julio-Septiembre 2021
ISSN 2007-8013

Neumotórax en pacientes COVID-19.

Pneumotorax in COVID-19 patients.

Israel Hernández-Rivera1*, Adrián Pamanes-Lozano2, Martín Adrián Bolívar-Rodríguez2.

  1. Médico Residente de 4°año de Cirugía General, Servicio de Cirugía General del Centro de Investigación y Docencia en Ciencias de la Salud de la universidad Autónoma de Sinaloa en el Hospital Civil de Culiacán. Sinaloa, México.
  2. Médico Especialista en Cirugía General, Servicio de Cirugía General del Centro de Investigación y Docencia en Ciencias de la Salud de la universidad Autónoma de Sinaloa en el Hospital Civil de Culiacán. Sinaloa, México.

*Autor de correspondencia: Dr. Israel Hernández-Rivera
Domicilio: Calle Eustaquio Buelna 91, Colonia Gabriel Leyva C.P. 80030, Culiacán, Sinaloa, México.
Teléfono: (331)2927192. Correo electrónico: maconto041@gmail.com

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v11.n3.009

Texto Completo PDF

Recibido 13 de Marzo 2021, aceptado 15 de Mayo 2021

RESUMEN
La pandemia por Covid-19 ha causado 34, 161 721 casos confirmados y más de 1, 016 986 muertes a nivel mundial. Se ha reportado en ciertos pacientes serias complicaciones como lo son: el síndrome de distrés respiratorio agudo y el neumotórax este último con una incidencia de 15 % y una tasa de mortalidad de 33% esto en los casos asociados a barotrauma. El Neumotórax se menciona como la presencia de aire libre en el espacio pleural, puede ocurrir durante las distintas fases de la enfermedad y puede relacionarse a enfermedad pulmonar subyacente, barotrauma por ventilación mecánica o gravedad de la enfermedad. El diagnóstico se realiza mediante la combinación clínica de signos y síntomas así como su confirmación mediante algún método diagnóstico de imagen como la tomografía de tórax los hallazgos característicos y poco comunes fue la presencia de neumatoceles o bullas. Se debe realizar un diagnóstico y tratamiento oportuno para la disminución de su tasa de mortalidad
Palabras clave: Neumotórax, Neumatocele, Barotrauma, Ventilación mecánica, Covid-19

ABSTRACT
The Covid-19 pandemic has caused 34,161 721 confirmed cases and more than 1,016 986 deaths worldwide. Serious complications have been reported in certain patients, such as: acute respiratory distress syndrome and pneumothorax, the latter with an incidence of 15% and a mortality rate of 33%, this in cases associated with barotrauma. Pneumothorax is mentioned as the presence of free air in the pleural space, it can occur during the different phases of the disease and can be related to underlying lung disease, barotrauma due to mechanical ventilation or severity of the disease. The diagnosis is made through the clinical combination of signs and symptoms as well as their confirmation by means of some diagnostic imaging method such as chest tomography. The characteristic and uncommon findings were the presence of pneumatoceles or bullae. A timely diagnosis and treatment must be carried out to reduce the mortality rate
Key words: Pneumothorax, Pneumatocele, Barotrauma, Mechanical ventilation, Covid-19

REFERENCIAS

  1. Organization, World Health. [homepage en internet]. Organization, World Health; [actualizada 24 septiembre 2020; consultado 24 septiembre 2020].Disponible https://covid19.who.int/?gclid=CjwKCAjwwab7BRBAEiwAapqpTOzP4C4J7UcQfW0s51-FGCgWDKJ8AiohQ7I1es7ASHLO5brl-vB6oRoC4XYQAvD_BwE.
  2. Abushahin A, Degliuomini J, Aronow WS, Newman T. A Case of Spontaneous Pneumothorax 21 Days After Diagnosis of Coronavirus Disease 2019 (COVID-19) Pneumonia. Am J Case Rep. 2020;21:e925787.
  3. Aydin S, Öz G, Dumanli A, Balci A, Gencer A. A Case of Spontaneous Pneumothorax in Covid-19 Pneumonia. J Surg Res. 2020;03(02): 96-101.
  4. Pérez O, Zamarrón E, Guerrero M, Soriano R, Figueroa A, López J, et al. Protocolo de manejo para la infección por COVID-19. Med Crit. 2020;33(1):43-52.
  5. Yang X, Yu Y, Xu J, Shu H, Xia Ja, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81.
  6. Zantah M, Dominguez E, Townsend R, Dikengil F, Criner GJ. Pneumothorax in COVID-19 disease- incidence and clinical characteristics. Respi Res. 2020;21(1):236.
  7. Martinelli AW, Ingle T, Newman J, Nadeem I, Jackson K, Lane N, et al. COVID-19 and pneumothorax: a multicentre retrospective case series. Eur Respir J.2020; 56 (5): 02697
  8. Aiolfi A, Biraghi T, Montisci A, Bonitta G, Micheletto G, Donatelli F, et al. Management of Persistent Pneumothorax with Thoracoscopy and Blebs Resection in Covid-19 Patients. Ann Thorac Surg. 2020.
  9. Alhakeem A, Khan MM, Al Soub H, Yousaf Z. Case Report: COVID-19-Associated Bilateral Spontaneous Pneumothorax-A Literature Review. Am J Trop Med Hyg. 2020;103(3):1162-5.
  10. Plojoux J, Froudarakis M, Janssens JP, Soccal PM, Tschopp JM. New insights and improved strategies for the management of primary spontaneous pneumothorax. Clin Respir J. 2019;13(4):195-201.
  11. Janssen ML, van Manen MJG, Cretier SE, Braunstahl GJ. Pneumothorax in patients with prior or current COVID-19 pneumonia. Respir Med Case Rep. 2020;31:101187.
  12. UpToDate. Anesi G. Coronavirus disease 2019 (COVID-19): Critical care and airway management issues. [last updated: Sep 14, 2020]. Disponible en: https://www-uptodate-com.pbidi.unam.mx:2443/contents/coronavirus-disease-2019-covid-19-critical-care-and-airway-management-issues?search=.%20Enfermedad%20por%20coronavirus%202019%20(COVID-19):%20cuidados%20cr%C3%ADticos%20y%20problemas%20de%20manejo%20de%20las%20v%C3%ADas%20respiratorias&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  13. Gulati A, Pomeranz C, Qamar Z, Thomas S, Frisch D, George G, et al. A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic. Am J Med Sci. 2020;360(1):5-34.
  14. Hussain A, Noorani A, Deshpande R, Jhon L, Baghai M, Wendler O, et al. "Manejo del neumotórax en pacientes con COVID-19 ventilados mecánicamente: experiencia inicial". Interact Cardiovasc Thorac Surg. 2020; 31(4): 540-543
  15. Shirai T, Mitsumura T, Aoyagi K, Okamoto T, Kimura M, Gemma T, et al. COVID-19 pneumonia complicated by bilateral pneumothorax: A case report. Respir Med Case Rep. 2020;31:101230.
  16. MacDuff A, Arnold A, Harvey J, Group BTSPDG. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65 Suppl 2:ii18-31.
  17. Flower L, Carter JL, Rosales Lopez J, Henry AM. Tension pneumothorax in a patient with COVID-19. BMJ Case Rep. 2020;13(5).
  18. López ZM, López ZD, Martínez CJ, Rodríguez SA, Gutiérrez LG, López RM. Neumomediastino espontáneo en pacientes con COVID-19. Emergencias. 2020; 32(4): 298-299
  19. Sun R, Liu H, Wang X. Mediastinal Emphysema, Giant Bulla, and Pneumothorax Developed during the Course of COVID-19 Pneumonia. Korean J Radiol. 2020;21(5):541-4.
  20. Chen X, Zhang G, Tang Y, Peng Z, Pan H. The coronavirus diseases 2019 (COVID-19) pneumonia with spontaneous pneumothorax: a case report. BMC Infect Dis. 2020;20(1):662.
  21. Mallick T, Dinesh A, Engdahl R, Sabado M. COVID-19 Complicated by Spontaneous Pneumothorax. Cureus. 2020;12(7):e9104.
  22. Xin LMD, Ruibing LMD. Diagnosis and Treatment of Severe COVID-19 Complicated with Spontaneous Pneumothorax: A Case Report. Advanced Ultrasound in Diagnosis and Therapy. 2020;4(2):142.
  23. McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason D, et al. High incidence of barotrauma in patients with COVID-19 infection on invasive mechanical ventilation. RSNA. 2020: 202352.
  24. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med. 2020;46(6):1099-102.
  25. Porcel JM. Pleural diseases and COVID-19: ubi fumus, ibi ignis.Eur Respir J. 2020; 56(5):2003308
  26. Sardenberg R, Sant' Ana J, Vicente A, Pereira A, Vertozzi P, Mano R. Recurrent pneumothorax in a COVID-19 patient: A case report. Respiratory Medicine Case Reports 31 (2020) 101201
  27. Tschopp JM, Bintcliffe O, Astoul P, Canalis E, Driesen P, Janssen J, et al. ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax. Eur Respir J. 2015;46(2):321-35.
  28. Marsico S, Bellido L, Zuccarino F. Spontaneous Pneumothorax in COVID-19 Patients. Arch Bronconeumol. 2020.
  29. Ferreira JG, Rapparini C, Gomes BM, Pinto LAC, Freire M. Pneumothorax as a late complication of COVID-19. Rev Inst Med Trop Sao Paulo. 2020;62:e61.
  30. Poggiali E, Vercelli A, Iannicelli T, Tinelli V, Celoni L, Magnacavallo A. COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad. Eur J Case Rep Intern Med. 2020;7(7):001742.
  31. Husain LF, Hagopian L, Wayman D, Baker WE, Carmody KA. Sonographic diagnosis of pneumothorax. J Emerg Trauma Shock. 2012;5(1):76-81.
  32. Gonzalez-Pacheco H, Gopar-Nieto R, Jimenez-Rodriguez GM, Manzur-Sandoval D, Sandoval J, Arias-Mendoza A. Bilateral spontaneous pneumothorax in SARS-CoV-2 infection: A very rare, life-threatening complication. Am J Emerg Med. 2020.
  33. 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. The Lancet. 2020;395(10223):507-13.
  34. Yang F, Shi S, Zhu J, Shi J, Dai K, Chen X. Analysis of 92 deceased patients with COVID-19. J Med Virol. 2020.
  35. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
  36. Weg J, Anzueto A, Balk R, Wiedemann H, Pattishall E, Schork M, et al. The relation of pneumothorax and other air leaks to mortality in the acute respiratory distress syndrome. NEJM. 1998; 338(6): 341-346.
  37. Carvalho EA, Oliveira MVB. Safety model for chest drainage in pandemic by COVID-19. Rev Col Bras Cir. 2020;47:e20202568.
  38. Pieracci FM, Burlew CC, Spain D, Livingston DH, Bulger EM, Davis KA, et al. Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees. Trauma Surg Acute Care Open. 2020;5(1):e000498.
  39. Sugimoto H, Kohama T. Chest tube with air leaks is a potential "super spreader" of COVID-19. Am J Infect Control. 2020;48(8):969.
  40. Bilkhu R, Viviano A, Saftic I, Billè A. COVID-19: Chest Drains With Air Leak-The Silent'Super Spreader. CTSNET Epub. 2020
  41. Khurram R, Johnson FTF, Naran R, Hare S. Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection. BMJ Case Rep. 2020;13(8).
  42. Quincho-Lopez A, Quincho-Lopez DL, Hurtado-Medina FD. Case Report: Pneumothorax and Pneumomediastinum as Uncommon Complications of COVID-19 Pneumonia-Literature Review. Am J Trop Med Hyg. 2020;103(3):1170-6.
  43. Núñez GI, Estrada V, Fernández PC, Fernández RI, Martín SF, Macaya C. Curva pandémica COVID-19, sobrecarga sanitaria y mortalidad. Emergencias. 2020; 32(4): 293-295.