Barotrauma may be related to the severity of COVID-19 and IMV. A subsequent large retrospective study found that pneumothorax/pneumomediastinum risk was significantly higher in COVID-19 (2211 patients) versus prepandemic acute respiratory distress syndrome (5522 patients) (adjusted odds ratio : 1.31, 95% CI: 1.13–1.52). A systematic review of 13 observational studies of patients with COVID-19 receiving IMV found that 266/1814 patients (14.7%) had at least one barotrauma event compared with 31/493 patients (6.3%) with non-COVID acute respiratory distress syndrome (based on data from 3 studies). One study observed that 89/601 patients (14.8%) who had COVID-19 and received IMV suffered from barotrauma, compared with only 1/196 patients (0.5%) who were admitted during the same period and tested negative for COVID and 31/285 patients (10.9%) with acute respiratory distress syndrome. ĬOVID-19 itself may increase the risk of pulmonary barotrauma. ![]() A systematic review of 15 observational studies of COVID-19 found barotrauma in 4.2% (95% confidence interval : 2.4–7.3%) of hospitalized patients, 15.6% (95% CI: 11–21.8%) of critically ill patients, and 18.4% (95% CI: 13–25.3%) of patients receiving invasive mechanical ventilation (IMV). Pulmonary barotrauma, defined as the aberrant presence of gas in extraalveolar locations, thus causing pneumothorax, pneumomediastinum, and/or subcutaneous emphysema, was commonly encountered in clinical practice and then described in observational studies. Critical illness may occur in patients with Coronavirus Disease 2019 (COVID-19), mainly in the form of severe pneumonia and acute hypoxemic respiratory failure, which may occur in 17–29% of hospitalized patients.
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