{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:25:49Z","timestamp":1783401949680,"version":"3.54.6"},"reference-count":20,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients\u2019 outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX\/PNM. Methods: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX\/PNM were compared. Results: Among 1213 patients, PNX and\/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX\/PNM showed higher in-hospital (p = 0.02) and 90-days mortality (p = 0.048), and longer hospitalization length (p = 0.002) than COVID-19 patients without PNX\/PNM. At PNX\/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX\/PNM occurrence was associated with longer symptom length before hospital admission (p = 0.005) and lower levels of blood lymphocytes (p = 0.017). Conclusion: PNX\/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation.<\/jats:p>","DOI":"10.3390\/jcm10214835","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:22:02Z","timestamp":1634862122000},"page":"4835","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Pneumothorax and\/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1796-8478","authenticated-orcid":false,"given":"Matteo","family":"Bonato","sequence":"first","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"},{"name":"Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Fraccaro","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Landini","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Zanardi","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo","family":"Catino","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Savoia","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Malacchini","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Zeraj","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piera","family":"Peditto","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Catalanotti","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliera-Universitaria, Division of Respiratory and Critical Care Sant\u2019Orsola Hospital, 40141 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Marcon","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale di Vittorio Veneto, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31029 Vittorio Veneto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Rossi","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale di Montebelluna, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31044 Montebelluna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Pauletti","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale di Montebelluna, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31044 Montebelluna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Galvan","sequence":"additional","affiliation":[{"name":"Internal Medicine II, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Adami","sequence":"additional","affiliation":[{"name":"Geriatric Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Tiepolo","sequence":"additional","affiliation":[{"name":"Internal Medicine I, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Salasnich","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Cuzzola","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Zampieri","sequence":"additional","affiliation":[{"name":"Pulmonology Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Rattazzi","sequence":"additional","affiliation":[{"name":"Internal Medicine I, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Peta","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8923-7511","authenticated-orcid":false,"given":"Simonetta","family":"Baraldo","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Saetta","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Morana","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ospedale C\u00e0 Foncello, Azienda Unit\u00e0 Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, 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