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Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient

INTRODUCTION: Patients with COVID-19 infection and severe lung parenchyma alterations may need mechanical ventilation with subsequent pneumothorax and eventually persistent air leak in case of pre-existing lung disease. PRESENTATION OF CASE: This report presents the case of a never-ventilated 58 yea...

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Autores principales: Caviezel, Claudio, Weiss, Lina, Haessig, Gabriela, Alfaré, Christian, Haberecker, Martina, Varga, Zsuzsanna, Frauenfelder, Thomas, Opitz, Isabelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527682/
https://www.ncbi.nlm.nih.gov/pubmed/33076191
http://dx.doi.org/10.1016/j.ijscr.2020.09.148
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author Caviezel, Claudio
Weiss, Lina
Haessig, Gabriela
Alfaré, Christian
Haberecker, Martina
Varga, Zsuzsanna
Frauenfelder, Thomas
Opitz, Isabelle
author_facet Caviezel, Claudio
Weiss, Lina
Haessig, Gabriela
Alfaré, Christian
Haberecker, Martina
Varga, Zsuzsanna
Frauenfelder, Thomas
Opitz, Isabelle
author_sort Caviezel, Claudio
collection PubMed
description INTRODUCTION: Patients with COVID-19 infection and severe lung parenchyma alterations may need mechanical ventilation with subsequent pneumothorax and eventually persistent air leak in case of pre-existing lung disease. PRESENTATION OF CASE: This report presents the case of a never-ventilated 58 years old male patient without pre-existing, underlying lung disease demonstrating severe lung parenchyma changes due to COVID-19-pneumonia. He suffered from recurrent bilateral spontaneous pneumothoraces, which were successfully treated with bilateral thoracoscopy and resections of the destroyed lung areas. Notably, he has already been under treatment with anticoagulation due to portal thrombosis 8 years ago. DISCUSSION: Although especially know from patients under mechanical ventilation, this patient suffered from spontaneous pneumothorax without ever been ventilated. Probably due to the severe vascular inflammatory changes and focal endothelitis like also seen in other organs of COVID-19 patients, the pneumothorax may lead to a prolonged air leak, which needs surgical therapy. The patients pre-existing anticoagulation therapy may prevented him from a mere severe course. CONCLUSION: Early surgical therapy may be considered in COVID-19 patients with persistent air leak, even if not mechanically ventilated. Simultaneously, the role of early anticoagulation needs further investigation.
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spelling pubmed-75276822020-10-05 Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient Caviezel, Claudio Weiss, Lina Haessig, Gabriela Alfaré, Christian Haberecker, Martina Varga, Zsuzsanna Frauenfelder, Thomas Opitz, Isabelle Int J Surg Case Rep Case Report INTRODUCTION: Patients with COVID-19 infection and severe lung parenchyma alterations may need mechanical ventilation with subsequent pneumothorax and eventually persistent air leak in case of pre-existing lung disease. PRESENTATION OF CASE: This report presents the case of a never-ventilated 58 years old male patient without pre-existing, underlying lung disease demonstrating severe lung parenchyma changes due to COVID-19-pneumonia. He suffered from recurrent bilateral spontaneous pneumothoraces, which were successfully treated with bilateral thoracoscopy and resections of the destroyed lung areas. Notably, he has already been under treatment with anticoagulation due to portal thrombosis 8 years ago. DISCUSSION: Although especially know from patients under mechanical ventilation, this patient suffered from spontaneous pneumothorax without ever been ventilated. Probably due to the severe vascular inflammatory changes and focal endothelitis like also seen in other organs of COVID-19 patients, the pneumothorax may lead to a prolonged air leak, which needs surgical therapy. The patients pre-existing anticoagulation therapy may prevented him from a mere severe course. CONCLUSION: Early surgical therapy may be considered in COVID-19 patients with persistent air leak, even if not mechanically ventilated. Simultaneously, the role of early anticoagulation needs further investigation. Elsevier 2020-09-24 /pmc/articles/PMC7527682/ /pubmed/33076191 http://dx.doi.org/10.1016/j.ijscr.2020.09.148 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Caviezel, Claudio
Weiss, Lina
Haessig, Gabriela
Alfaré, Christian
Haberecker, Martina
Varga, Zsuzsanna
Frauenfelder, Thomas
Opitz, Isabelle
Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient
title Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient
title_full Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient
title_fullStr Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient
title_full_unstemmed Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient
title_short Case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy COVID-19-patient
title_sort case report of sequential bilateral spontaneous pneumothorax in a never-ventilated, lung-healthy covid-19-patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527682/
https://www.ncbi.nlm.nih.gov/pubmed/33076191
http://dx.doi.org/10.1016/j.ijscr.2020.09.148
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