ArticleChest2021
Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
Article in Chest, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Effects of pulmonary air leak on patients with coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis.BMC pulmonary medicine · 2023Pooled it
- The incidence, clinical characteristics, and outcomes of pneumothorax in hospitalized COVID-19 patients: A systematic review.Heart & lung : the journal of critical carePooled it
- Trends and Disparities in Pneumothorax-Related Deaths in the United States Before and During the COVID-19 Pandemic: A CDC WONDER Database Analysis.Public health challenges · 2026Article
- Prognostic Implications of Pneumothorax and Pneumomediastinum in COVID-19 Pneumonia: A Cross-Sectional Analysis.The open respiratory medicine journal · 2026Article
- Coronavirus disease 2019 pneumonia with concomitant spontaneous pneumomediastinum, pneumothorax, and subcutaneous emphysema in a non-ventilated patient, complicated by pulmonary embolism: a case report.Journal of medical case reports · 2025Article
- Contribution of lung ultrasound to assess COVID-19 pneumonia in critical care setting: a prospective cohort study.Scientific reports · 2025Article
- Pneumothorax and Pneumomediastinum in SARS-CoV-2 Infection.Medicina (Kaunas, Lithuania) · 2025Article
- Effect of environmental factors on postoperative recurrent primary spontaneous pneumothorax: a case-crossover study.Respiratory research · 2025Article
- Patients with coronavirus disease 2019 and spontaneous pneumothorax: a propensity-matched, multicentre case-control study.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Risk factors affecting the development of pneumothorax in patients followed up in intensive care with a diagnosis of COVID-19.BMC infectious diseases · 2024Observational
- Article
- Comparison of the risk of pneumothorax in COVID-19 and seasonal influenza.Scientific reports · 2024Article
- Pneumomediastinum and pneumothorax in coronavirus disease-2019: Description of a case series and a matched cohort study.Heliyon · 2024Article
- Prevalence and patient risk factors for pneumothorax in COVID-19 and in influenza pneumonia: a nationwide comparative analysis.Journal of thoracic disease · 2024Article
- Complications during Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2024Article
- Predictors of Mortality and Orotracheal Intubation in Patients with Pulmonary Barotrauma Due to COVID-19: An Italian Multicenter Observational Study during Two Years of the Pandemic.Journal of clinical medicine · 2024Article
- COVID-19 Pneumonia Associated with Pneumomediastinum and Pneumothorax: Epidemiology and Evolution.Tanaffos · 2024Article
- Respiratory mechanics characteristics at the time of barotrauma presentation in patients with critical COVID-19 infection.Critical care science · 2024Article
- Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with COVID-19: Three-Year Debriefing across Five Pandemic Waves.Journal of personalized medicine · 2023Article
- The prognostic effect of concomitant COVID-19 with spontaneous pneumothorax.Turk gogus kalp damar cerrahisi dergisi · 2023Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on byResponse.2021
Authors and funding
21 authors at 12 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent 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
methodsThis 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.
resultsWe 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.
interpretationSP 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.
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