Evaluation of Pleural Complications Affecting Mortality in COVID-19 Patients/COVID-19 Hastalarinda Mortaliteye Etki Eden Plevral Komplikasyonlarin Degerlendirilmesi

• Published in: Southern Clinics of Istanbul Eurasia (SCIE) Vol. 33; no. 3; p. 270
• Main Authors: Akboga, Suleyman Anil, Gokce, Anil, Hatipoglu, Merve, Sezen, Aysegul Inci, Akkas, Yucel, Erdem, Deniz, Kocer, Bulent
• Format: Journal Article
• Language: Turkish
• Published: KARE Publishing 01.09.2022
• Subjects: Pleural diseases; Prognosis; Risk factors; Turkey
• ISSN: 2587-0998
• DOI: 10.14744/scie.2022.69345

Objective: This study aimed to retrospectively evaluate pleural complications in patients who were polymerase chain reaction (PCR)-positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and admitted to the hospital with COVID-19 pneumonia. Methods: A total of 164 patients who applied to our hospital between March 2020 and May 2021 with PCR-positive for SARS-CoV-2 were retrospectively evaluated and were followed up and treated in the service or intensive care unit. Pleural complications were detected during the treatment of COVID-19 pneumonia. In the current study, mortality was taken as the death of the patients in the first 30 days after hospitalization. Pleural complications occurring during treatment were classified into two groups: the pneumothorax (PNX) group and the pneumomediastinum (PMN) group. Results: Of the patients, 69 (52.3%) had isolated PNX and 14 (43.7%) had isolated PMN. PNX and subcutaneous emphysema were determined in 50 (37.9%) patients, PMN and subcutaneous emphysema were determined in 13 (40.6%), PMN, PNX, and subcutaneous emphysema were determined in 3 (9.4%), and PMN and PNX were determined in 2 (6.3%) patients. Hydro-PNX was determined in 12 (9.1%) patients, and PNX and empyema were determined in 1 (0.7%) patient. When the relationship between pleural complications occurring during treatment due to COVID-19 pneumonia and mortality was examined, mortality was observed in 14 (43.8%) of the PMN patients and 104 (78.8%) of the PNX patients (p<0.001). When the relationship between gender and mortality was examined, mortality was observed in 75 (65.8%) of the male patients and in 43 (86%) of the female patients (p=0.008). Conclusion: As a result, it was found that PNX after positive pressure ventilation increased mortality more than other pleural complications and worsened the prognosis. We think this issue will contribute to the literature in the COVID-19 pandemic and in pandemic diseases that may occur later and cause pleural involvement. Keywords: Mortality pleural complication; pneumomediastinum; pneumothorax. Amac: Bu calismada SARS-CoV-2 pcr pozitifligi saptanan ve COVID-19 pnomonisi ile hastaneye basvuran hastalarda meydana gelen plevral komplikasyonlarin geriye donuk olarak degerlendirilmesi amaclandi. Gerec ve Yontem: Mart 2020-Mayis 2021 tarihleri arasinda hastanemize basvuran ve SARS-CoV-2 pcr pozitifligi saptanan ve COVID-19 pnomonisi tedavisi sirasinda plevral komplikasyonlarin saptandigi servis veya yogun bakimlarda takip ve tedavi edilen 164 hasta retrospektif olarak degerlendirildi. Calismamizda mortalite hastalarin hastaneye yatis sonrasi ilk 30 gundeki olumleri olarak alindi. Tedavi sirasinda meydana gelen plevral komplikasyonlar pnomotoraks ve pnomomediastinum olarak 2 grupta siniflandirilmistir. Bulgular: Hastalarimizin 69'unda (%52.3) izole PNX, 14'unde (%43.7) izole PMN mevcuttur. 50'sinde PNX ve subkutan amfizem (%37.9), 13'sinde (%40.6) PMN ve subkutan amfizem, ucunde (%9.4) PMN, PNX ve subkutan amfizem, ikisinde (%6.3) PMN ve PNX 12'sinde (%9.1) hidropnomotoraks ve birinde (%0.7) de PNX ve ampiyem birlikteligi mevcuttur. Hastalarda COVID-19 pnomonisi sebebiyle tedavi sirasinda meydana gelen plevral komplikasyon ile mortalite arasindaki iliski incelendiginde PMN hastalarinin 14'unde (%43.8) mortalite gorulmesine ragmen PNX hastalarinin 104'unde (%78.8) mortalite gorulmustur (p<0.001). Cinsiyet ile mortalite arasindaki iliski incelendiginde erkek hastalarin 75'inde (%65.8) mortalite gorulmusken kadin hastalarin ise 43'unde (%86) mortalite gorulmustur (p=0.008). Sonuc: Sonuc olarak pozitif basincli ventilasyon sonrasi meydana gelen pnomotoraks durumunun meydana gelen diger plevral komplikasyonlara gore mortaliteyi daha cok artirdigini, prognozu ise daha cok agirlastirdigini saptadik. COVID-19 pandemisi ile bundan sonra ortaya cikabilecek ve plevral tutulum meydana getirebilecek pandemik hastaliklarda bu hususun literature katki saglayacagini dusunuyoruz. Anahtar Sozcukler: Mortalite; plevral komplikasyon; pnomomediastinum; pnomotoraks.