Spontaneous Pneumothorax in COVID-19 Patients Treated with High-Flow Nasal Cannula outside the ICU: A Case Series

Magdalena Nalewajska, Wiktoria Feret, Łukasz Wojczyński, Wojciech Witkiewicz, Magda Wiśniewska and Katarzyna Kotfis
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Magdalena Nalewajska: Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70–111 Szczecin, Poland
Wiktoria Feret: Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70–111 Szczecin, Poland
Łukasz Wojczyński: Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70–111 Szczecin, Poland
Wojciech Witkiewicz: Department of Cardiology, Pomeranian Medical University, 70–111 Szczecin, Poland
Magda Wiśniewska: Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70–111 Szczecin, Poland
Katarzyna Kotfis: Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70–111 Szczecin, Poland

IJERPH, 2021, vol. 18, issue 4, 1-12

Abstract: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic and a burden to global health at the turn of 2019 and 2020. No targeted treatment for COVID-19 infection has been identified so far, thus supportive treatment, invasive and non-invasive oxygen support, and corticosteroids remain a common therapy. High-flow nasal cannula (HFNC), a non-invasive oxygen support method, has become a prominent treatment option for respiratory failure during the SARS-CoV-2 pandemic. HFNC reduces the anatomic dead space and increases positive end-expiratory pressure (PEEP), allowing higher concentrations and higher flow of oxygen. Some studies suggest positive effects of HFNC on mortality and avoidance of intubation. Spontaneous pneumothorax has been observed in patients suffering from SARS-CoV-2 pneumonia. Although the viral infection itself contributes to its development, higher PEEP generated by both HFNC and mechanical ventilation is another risk factor for increased alveoli damage and air-leak. Herein, we present three cases of patients with no previous history of lung diseases who were diagnosed with COVID-19 viral pneumonia. All of them were supported with HFNC, and all of them presented spontaneous pneumothorax.

Keywords: coronavirus; COVID-19; HFNC; SARS-CoV-2; pneumothorax (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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