TY - JOUR T1 - Increased frequency of pneumothorax and pneumomediastinum in COVID-19 patients admitted in the ICU: A multicentre study from Mumbai, India JF - Clinical Medicine JO - Clin Med SP - e615 LP - e619 DO - 10.7861/clinmed.2021-0220 VL - 21 IS - 6 AU - Zarir F Udwadia AU - Kedar K Toraskar AU - Lancelot Pinto AU - Jai Mullerpatan AU - Haresh D Wagh AU - Joanne M Mascarenhas AU - Bhavesh M Gandhi AU - Awatansh Tripathi AU - Ayesha Sunavala AU - Umang Agrawal AU - Viral Nanda AU - Nikita Abraham AU - Bony Francis AU - Ravindra R Zore AU - Gurudas Pundpal AU - Bhoosan Gondse AU - Gaurav A Gupta Y1 - 2021/11/01 UR - http://www.rcpjournals.org/content/21/6/e615.abstract N2 - Background There are limited data regarding the incidence of pneumothorax in COVID-19 patients as well as the impact of the same on patient outcomes.Methods A retrospective review of the medical records at three large tertiary care hospitals in Mumbai was performed to identify patients hospitalised with COVID-19 from March 2020 to October 2020. The presence of pneumothorax and/or pneumomediastinum was noted when chest radiographs or CT scans were performed. Demographic and clinical characteristics of patients who developed air leak were recorded.Results 4,906 patients with COVID-19 were admitted, with 1,324 (27%) having severe COVID-19 disease. The overall incidence of pneumothorax and/or pneumomediastinum in patients with severe disease was 3.2% (42/1,324). Eighteen patients had pneumothorax, 16 had pneumomediastinum and 8 patients had both. Fourteen patients (33.3%) developed this complication breathing spontaneously, 28 patients (66.6%) developed it during mechanical ventilation. Overall mortality in this cohort was 74%, compared with 17% in the COVID-19 patients without pneumothorax (p<0.001).Conclusions Our study demonstrates that air leaks occur with a higher frequency in patients with COVID-19 than in other ICU patients. When present, such air leaks contributed to poor outcomes with almost 74% mortality rates in these patients. ER -