Determinants of Pneumothorax Among Mechanically Ventilated COVID-19 Intensive Care Unit Patients, a Single Centre Study

Abstract

Introduction

Millions of deaths and co-morbidities have been brought on by the COVID-19 epidemic worldwide. Acute respiratory distress syndrome (ARDS), multiple organ failure, and death can result from the condition in some people. The disease’s course can range from a moderate upper respiratory tract infection to severe pneumonia. Numerous reports have been made on the occurrence of pneumothorax in COVID-19 ICU patients, particularly in those who are receiving invasive ventilation. This study assesses factors associated with pneumothorax among mechanically ventilated COVID-19 ICU patients in Addis Ababa, Ethiopia.

Methods

A case-control study design was employed from August 1, 2022, to August 31, 2022, GC, with a sample size of 281, where cases are 94 and controls are 187. A pre-tested structured quantitative tool was used to collect data on ODK and export it to SPSS version 26 for analysis. Descriptive statistics were presented using text and tables. The association between variables was analyzed with binary logistic regression. A statistical significance was declared at a p-value of 0.05 with a 95% confidence interval. Assumptions like model fitness and multicollinearity were checked to be satisfied.

Results

A total of 281 (94 cases and 187 controls) patient charts were carefully reviewed. After adjustment for possible confounders in multivariate analysis, ARDS (AOR = 0.214, 95% CI (0.088, 0.519), P value =0.001) and invasive ventilation (AOR = 0.311, 95% CI (0.121, 0.796), P value =0.015) had a significant association with pneumothorax.

Conclusion

Despite the introduction of preventive breathing methods, pneumothorax is still a frequent and deadly consequence in COVID-19 patients with ARDS. ARDS and invasive mechanical ventilation were found to be significantly associated with the development of pneumothorax. Health facilities should be well equipped with recent medical equipment in intensive care units and with well-trained and organized manpower.

Keywords:

• pneumothorax
• mechanical ventilation
• intensive care unit
• Eka Kotebe General Hospital
• COVID-19

Abbreviations

ARDS, acute respiratory distress syndrome; CLD, chronic lung disease; COPD, chronic obstructive pulmonary disease; FIO2, fraction of inspired oxygen; MERS, Middle East Respiratory Syndrome; PEEP, positive end-expiratory pressure; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus-2; SP, spontaneous pneumothorax.

Acknowledgments

We would like to thank Eka Kotebe General Hospital for giving the ethical clearance letter timely and we would like to pass our gratitude to GAMBY Medical and Business College, data collectors, and supervisors.

Disclosure

The authors report no conflicts of interest in this work.