RT Journal Article SR Electronic 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 FD Royal College of Physicians SP e615 OP e619 DO 10.7861/clinmed.2021-0220 VO 21 IS 6 A1 Zarir F Udwadia A1 Kedar K Toraskar A1 Lancelot Pinto A1 Jai Mullerpatan A1 Haresh D Wagh A1 Joanne M Mascarenhas A1 Bhavesh M Gandhi A1 Awatansh Tripathi A1 Ayesha Sunavala A1 Umang Agrawal A1 Viral Nanda A1 Nikita Abraham A1 Bony Francis A1 Ravindra R Zore A1 Gurudas Pundpal A1 Bhoosan Gondse A1 Gaurav A Gupta YR 2021 UL http://www.rcpjournals.org/content/21/6/e615.abstract AB 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.