{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:42:49Z","timestamp":1760244169081,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>It is known that pneumothorax (PX) and pneumomediastinum (PM) develop due to COVID-19 disease. The objective of our study was to determine the prevalence of PX\/PM due to COVID-19 in the intermediate intensive care unit (IMCU) and to evaluate the factors causing barotrauma and also the clinical outcomes of these patients. A total of 283 non-intubated patients with COVID-19 pneumonia followed up in the IMCU in a 1-year period were included in the study. The patients were classified as group 1 (having barotrauma) and group 2 (without barotrauma). The rate of barotrauma was 8.1% (n = 23, group 1). PX developed on the right hemithorax in 12 (70.6%) patients. Group 1 had statistically significantly higher 28-day mortality rates compared with group 2 (p = 0.014). The eosinophil and d-dimer levels of the patients in group 1 were higher, while C-reactive protein (CRP), fibrinogen, and albumin levels were lower than Group 2 (p &lt; 0.001, p = 0.017, p = 0.001, p &lt; 0.001), and p &lt; 0.001, respectively). The similar rates of NIMV administration in our study groups support that barotrauma is not the only mechanism in the development of PX\/PM. The findings of high blood eosinophil count and low blood levels of CRP, albumin, and fibrinogen in the barotrauma group of our study might be a pathfinder for future studies.<\/jats:p>","DOI":"10.3390\/jpm12111863","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T08:52:56Z","timestamp":1667897576000},"page":"1863","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Prevalence of Barotrauma and Affecting Factors in Patients with COVID-19 during Follow-Up in the Intermediate Care Unit"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7006-5550","authenticated-orcid":false,"given":"Ayse","family":"Bahadir","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Basaksehir, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-7035","authenticated-orcid":false,"given":"Sinem","family":"Iliaz","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Memorial Bah\u00e7elievler Hospital, Bahcelievler, Istanbul 34180, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-118X","authenticated-orcid":false,"given":"Mehmet","family":"Hursitoglu","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Bak\u0131rkoy Dr. Sadi Konuk Training and Research Hospital, Bakirkoy, Istanbul 34147, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gul","family":"Unalan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Basaksehir, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sibel","family":"Yurt","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Basaksehir, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Akif","family":"Ozgul","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Basaksehir, Istanbul 34480, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1183\/09059180.00005310","article-title":"Spontaneous pneumothorax: Epidemiology, pathophysiology and cause","volume":"19","author":"Noppen","year":"2010","journal-title":"Eur. Respir. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.hrtlng.2021.04.005","article-title":"The incidence, clinical characteristics, and outcomes of pneumothorax in hospitalized COVID-19 patients: A systematic review","volume":"50","author":"Chong","year":"2021","journal-title":"Heart Lung."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2002697","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":"ref_4","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.hrtlng.2021.01.020","article-title":"Spontaneous pneumothorax: An emerging complication of COVID-19 pneumonia","volume":"50","author":"Ekanem","year":"2021","journal-title":"Heart Lung."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s40560-021-00593-1","article-title":"Noninvasive respiratory support for COVID-19 patients: When, for whom, and how?","volume":"10","author":"Sullivan","year":"2022","journal-title":"J. Intensive Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"103221","DOI":"10.1016\/j.amsu.2021.103221","article-title":"Pulmonary barotrauma in COVID-19: A systematic review and meta-analysis","volume":"73","author":"Shrestha","year":"2022","journal-title":"Ann. Med. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Nalewajska, M., Feret, W., Wojczy\u0144ski, L., Witkiewicz, W., Wi\u015bniewska, M., and Kotfis, K. (2021). Spontaneous pneumothorax in COVID-19 patients treated with high-flow nasal cannula outside the ICU: A case series. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042191"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4519","DOI":"10.21037\/jtd-21-208","article-title":"Pneumothorax in otherwise healthy non-intubated patients suffering from COVID-19 pneumonia: A systematic review","volume":"13","author":"Agrafiotis","year":"2021","journal-title":"J. Thorac. Dis."},{"key":"ref_9","unstructured":"(2022, July 20). COVID-19 Guide, Republic of Turkey Ministry of Health Directorate General of Public Health (T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 COVID-19 Bilgilendirme Platformu, COVID-19 Rehberi), Available online: https:\/\/covid19.saglik.gov.tr\/TR-66301\/covid-19-rehberi.html."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","article-title":"User\u2019s guide to correlation coefficients","volume":"18","author":"Akoglu","year":"2018","journal-title":"Turk. J. Emerg. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.chest.2020.11.013","article-title":"Frequency, risk factors, clinical characteristics, and outcomes of spontaneous pneumothorax in patients with Coronavirus disease 2019: A case-control, emergency medicine-based multicenter study","volume":"159","author":"Llorens","year":"2021","journal-title":"Chest"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bonato, M., Fraccaro, A., Landini, N., Zanardi, G., Catino, C., Savoia, F., Malacchini, N., Zeraj, F., Peditto, P., and Catalanotti, V. (2021). 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. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214835"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E252","DOI":"10.1148\/radiol.2020202352","article-title":"Incidence of barotrauma in patients with COVID-19 infection on invasive mechanical ventilation","volume":"297","author":"Mcguinness","year":"2020","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1017\/S0950268821001291","article-title":"Serious complications in COVID-19 ARDS cases: Pneumothorax, pneumomediastinum, subcutaneous emphysema and haemothorax","volume":"149","author":"Guven","year":"2021","journal-title":"Epidemiol. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"730","DOI":"10.12669\/pjms.38.3.5529","article-title":"Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in critically ill COVID-19 patients: A systematic review","volume":"38","author":"Shahsavarinia","year":"2022","journal-title":"Pak. J. Med. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1001\/jama.2021.4682","article-title":"Effect of helmet noninvasive ventilation vs high-flow nasal oxygen on days free of respiratory support in patients with COVID-19 and moderate to severe hypoxemic respiratory failure: The HENIVOT randomized clinical trial","volume":"325","author":"Grieco","year":"2021","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40560-015-0084-5","article-title":"High-flow nasal cannula oxygen therapy in adults","volume":"3","author":"Nishimura","year":"2015","journal-title":"J. Intensive Care."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s00134-016-4653-4","article-title":"Effects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome","volume":"43","author":"Guervilly","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"00385","DOI":"10.1183\/23120541.00385-2020","article-title":"Pneumomediastinum and subcutaneous emphysema in COVID-19: Barotrauma or lung frailty?","volume":"6","author":"Lemmers","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1097\/CCM.0000000000004895","article-title":"The Surviving Sepsis Campaign: Research Priorities for Coronavirus Disease 2019 in Critical Illness","volume":"49","author":"Coopersmith","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2156","DOI":"10.1038\/s41379-020-00661-1","article-title":"COVID-19 pulmonary pathology: A multi-institutional autopsy cohort from Italy and New York City","volume":"33","author":"Borczuk","year":"2020","journal-title":"Mod. Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S2213-2600(20)30076-X","article-title":"Pathological findings of COVID-19 associated with acute respiratory distress syndrome","volume":"8","author":"Xu","year":"2020","journal-title":"Lancet Respir Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/joim.13144","article-title":"Cytokine storm syndrome in coronavirus disease 2019: A narrative review","volume":"289","author":"Gao","year":"2021","journal-title":"J. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group, Horby, P., Lim, W.S., Emberson, J.R., Mafham, M., Bell, J.L., and Linsell, L. (2021). Dexamethasone in hospitalized patients with Covid-19. N. Engl. J. Med., 384, 693\u2013704.","DOI":"10.1056\/NEJMoa2021436"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"REMAP-CAP Investigators (2021). Interleukin-6 receptor antagonists in critically ill patients with Covid-19. N. Engl. J. Med., 384, 1491\u20131502.","DOI":"10.1056\/NEJMoa2100433"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.ejcdt.2014.10.006","article-title":"Predictive value of C-reactive protein in critically ill patients who develop acute lung injury","volume":"64","author":"Mahrous","year":"2015","journal-title":"Egypt. J. Chest Dis. Tuberc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaci.2020.04.021","article-title":"Eosinophil responses during COVID-19 infections and coronavirus vaccination","volume":"146","author":"Lindsley","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e312","DOI":"10.1055\/s-0041-1732340","article-title":"Nebulized heparin for post-COVID-19\u2013related hypoxia","volume":"5","author":"Hursitoglu","year":"2021","journal-title":"TH Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1183\/09031936.04.00079304","article-title":"Characterisation of pleural inflammation occurring after primary spontaneous pneumothorax","volume":"23","author":"DeSmedt","year":"2004","journal-title":"Eur. Respir. J."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/11\/1863\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:12:07Z","timestamp":1760145127000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/11\/1863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,7]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["jpm12111863"],"URL":"https:\/\/doi.org\/10.3390\/jpm12111863","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2022,11,7]]}}}