{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:31:23Z","timestamp":1740162683702,"version":"3.37.3"},"reference-count":13,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007833","name":"Hamad Medical Corporation","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100007833","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To study the incidence, characteristics, treatment, associated risk factors and outcome of COVID-19-associated pneumothorax in intensive care unit (ICU).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational data review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A multicentre study from ICUs of three tertiary care hospitals in Qatar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>1788 patients with COVID-19 pneumonia requiring ICU admission from 1 March 2020 to 1 November 2020 were enrolled in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>The primary endpoint was to identify the incidence of COVID-19-associated pneumothorax in patients requiring ICU admission. Secondary endpoints were to determine the associated risk factors, treatment, mortality and morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1788 patients from 3 centres were reviewed in the study. The total episodes of pneumothorax were 75. Pneumothorax occurred in 4.2% of the patients with COVID-19 pneumonia requiring ICU admission. The majority of the subjects were male (n=72, 96%). The mean age was 55.1 (\u00b112.7 years). The majority of the subjects were nationals of South Asian countries and the Middle East and North Africa regions. 52% (n=39) of the patients were previously healthy without comorbidities before ICU admission. The recurrence rate was 9.3%. The median length of ICU stay was 28 days (20.5\u201345.8\u2009days). After developing pneumothorax, the length of mechanical ventilation ranged from 6 to 32 days, with a median of 13 days. 44% of patients eventually ended up with tracheostomy. In-hospital mortality in the patients with COVID-19-related pneumothorax was 53.3% (n=40). The odds of mortality in patients with COVID-19 pneumonia with pneumothorax is 7.15 (95% CI 4.45 to 11.48, p&lt;0.0001) compared with those who did not develop pneumothorax. This indicates pneumothorax is a potential independent risk factor associated with mortality in patients with COVID-19 pneumonia requiring ICU admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pneumothorax is a common complication in patients with COVID-19 requiring ICU admission, associated with poor prognosis and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>The study was approved by the Medical Research Centre (MRC) Qatar. (MRC-01-20-1116).<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053398","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T17:05:53Z","timestamp":1645463153000},"page":"e053398","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Epidemiological and outcome analysis of COVID-19-associated pneumothorax: multicentre retrospective critical care experience from Qatar"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4487-014X","authenticated-orcid":false,"given":"Jaweria","family":"Akram","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4631-9899","authenticated-orcid":false,"given":"Zohaib","family":"Yousaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-7565","authenticated-orcid":false,"given":"Yasir","family":"Alabbas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa Ibrahim Abdullah","family":"Almoyaaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdus Salam Saif","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadir","family":"Kharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,21]]},"reference":[{"key":"2022022109052007000_12.2.e053398.1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-206995"},{"key":"2022022109052007000_12.2.e053398.2","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00011-020-01401-6","article-title":"The coagulopathy, endotheliopathy, and vasculitis of COVID-19","volume":"69","author":"Iba","year":"2020","journal-title":"Inflamm Res"},{"key":"2022022109052007000_12.2.e053398.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"2022022109052007000_12.2.e053398.4","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study","volume":"8","author":"Yang","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2022022109052007000_12.2.e053398.5","doi-asserted-by":"crossref","unstructured":"Yang F , Shi S , Zhu J . Analysis of 92 deceased patients with COVID-19. J Med Virol 2020.","DOI":"10.1002\/jmv.25972"},{"key":"2022022109052007000_12.2.e053398.6","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.02697-2020","article-title":"COVID-19 and pneumothorax: a multicentre retrospective case series","volume":"56","author":"Martinelli","year":"2020","journal-title":"Eur Respir J"},{"key":"2022022109052007000_12.2.e053398.7","doi-asserted-by":"crossref","first-page":"E252","DOI":"10.1148\/radiol.2020202352","article-title":"Increased incidence of barotrauma in patients with COVID-19 on invasive mechanical ventilation","volume":"297","author":"McGuinness","year":"2020","journal-title":"Radiology"},{"key":"2022022109052007000_12.2.e053398.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235653"},{"key":"2022022109052007000_12.2.e053398.9","doi-asserted-by":"crossref","unstructured":"Zantah M , Dominguez Castillo E , Townsend R , et al . 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