COVID-19 pneumothorax in the UK: a prospective observational study using the ISARIC WHO clinical characterisation protocol.
The European respiratory journal
European Respiratory Society
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Marciniak, S., Farrell, J., Rostron, A., Smith, I., Openshaw, P. J., Baillie, J. K., Docherty, A., & et al. (2021). COVID-19 pneumothorax in the UK: a prospective observational study using the ISARIC WHO clinical characterisation protocol.. The European respiratory journal, 58 (3) https://doi.org/10.1183/13993003.00929-2021
Pneumothorax is an important complication of 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 non-invasive 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 to June 2020, use of non-invasive 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, speculating that dexamethasone use might have been causal (6).
Humans, Pneumothorax, World Health Organization, Observational Studies as Topic, United Kingdom, COVID-19, SARS-CoV-2
This work is supported by grants from: the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059), and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford (award 200907), NIHR HPRU in Respiratory Infections at Imperial College London with PHE (award 200927), Wellcome Trust and Department for International Development (DID; 215091/Z/18/Z), the Bill and Melinda Gates Foundation (OPP1209135), Liverpool Experimental Cancer Medicine Centre (grant reference C18616/A25153), NIHR Cambridge Biomedical Research Centre (BRC-1215-20014) NIHR Imperial College London Biomedical Research Centre (IS-BRC-1215-20013), EU Platform for European Preparedness Against (Re-)emerging Epidemics (PREPARE; FP7 project 602525), and NIHR Clinical Research Network for providing infrastructure support for this research.
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External DOI: https://doi.org/10.1183/13993003.00929-2021
This record's URL: https://www.repository.cam.ac.uk/handle/1810/322468
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