Spontaneous pneumothorax as unusual presenting symptom of COVID-19 pneumonia: surgical management and pathological findings

Journal of Cardiothoracic Surgery

Serena Cuttin¹  Paolo Scarpazza²  Christian Cotsoglou³  Roberto Bellini³  Maria Chiara Salandini³  Stefania Mauro⁴ 

[1] Department of Pathology, Vimercate Hospital, Vimercate, Italy;Department of Pneumology, Vimercate Hospital, Vimercate, Italy;Department of Surgery, General Surgery Division, Vimercate Hospital, Vimercate, Italy;Milan Study University, Milan, Italy;

关键词: Pneumothorax;    COVID-19;    Thoracoscopy;    Case report;    Bullectomy;    Pathology;   

DOI  :  10.1186/s13019-020-01343-4

来源: Springer

【 摘 要 】

BackgroundSpontaneous pneumothorax has been reported as a possibile complication of novel coronavirus associated pneumonia (COVID-19). We report two cases of COVID-19 patients who developed spontaeous and recurrent pneumothorax as a presenting symptom, treated with surgical procedure. An insight on pathological finding is given.Case presentationTwo patients presented to our hospital with spontaneous pneumothorax associated with Sars-Cov2 infection onset. After initial conservative treatment with chest drain, both patients had a recurrence of pneumothorax during COVI-19 disease, contralateral (patient 1) or ipsilateral (patient 2) and therefore underwent lung surgery with thoracoscopy and bullectomy. Intraoperative findings of COVID-19 pneumonia were parenchymal atelectasis and vascular congestion. Lung tissue was very frail and prone to bleeding.Histological examination showed interstitial infiltration of lymphocytes and plasma cells, as seen in non specific interstitial pneumonia, together with myo-intimal thicknening of vessels with blood extravasation and microthrombi.ConclusionsAlthough rarely, COVID-19 may present with spontaneous pneumothorax. Lung surgery for pneumothorax in COVID-19 patients can be safely and effectively performed when necessary.

【 授权许可】

CC BY