Outcome and follow-up
Of the 1061 patients, 599 were men and 462 were women. The average age of the patients was 68.4 (16-103) years, and they were admitted to this field hospital between May 18, 2020 and February 28, 2021. The number of patients with pneumothorax was eight (three men and five women; Table 1), with an incidence of 0.75%. All patients had preceding pneumonia on CT at admission, except for a young patient (no. 8) who was considered to have complicated primary spontaneous pneumothorax. All patients were over 80 years old, except for one woman, who was 20 years old. At the time of diagnosis of pneumothorax, four patients were administered oxygen with a nasal cannula, and the other four were not administered oxygen. The mean age of patients with pneumothorax was 79.9 (20-96) years. Considering the laterality of pneumothorax, six were on the left side, and two on the right. Four patients required tube drainage and the other four were managed with conservative measures.
Six of the eight patients died (75%) after an average of 9.3 (1-32) days from the onset of pneumothorax. All patients who died did not consent to intubation or resuscitation, although they received conservative therapy including the administration of oxygen, remdesivir, favipiravir, antibiotics, anticoagulants, steroids, and nutrition therapy. The mean duration between onset of COVID-19 and pneumothorax was 20.3 (4-37) days. Two patients were current smokers and two were past smokers. The smoking status of the other four patients was unknown. Two patients had a history of chronic obstructive pulmonary disease. Six of the eight patients were administered dexamethasone and the onset of pneumothorax occurred after an average of 19.8 (3-32) days from its initiation. With age limited to over 80 years, the mortality in COVID-19 pneumothorax patients was high (85.7%, six of seven).