Pneumothorax is an important complication of coronavirus disease 2019 (COVID-19) [12]. Based on a series of 60 individuals, we previously estimated that 0.91% of people admitted to hospital with COVID-19 develop pneumothorax [1]. Males accounted for three quarters of those affected, and patients requiring noninvasive or invasive ventilatory support appeared at elevated risk. In a separate series of ventilated patients with COVID-19, barotrauma, defined as pneumothorax or pneumomediastinum, was found to be an independent risk for death [2]. During the pandemic, treatment strategies have evolved, influenced by large randomised controlled trials and clinical experience. Following the landmark results from the RECOVERY trial [3], dexamethasone became standard of care for patients requiring supplemental oxygen. Following the first UK wave between March and June 2020, use of noninvasive respiratory support became more common [45]. Such changes could plausibly alter the incidence of pneumothorax caused by COVID-19. Indeed, a recent small study reported an increase in pneumothoraces in the second wave of COVID-19 in Italy, leading to speculation that dexamethasone use might have been causal


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Marciniak, S., Farrell, J., Rostron, A., Smith, I., Openshaw, P., Baillie, J., Docherty, A. & Semple, M. 2021, 'COVID-19 Pneumothorax in the United Kingdom:a prospective observational study using the ISARIC WHO clinical characterisation protocol', European Respiratory Journal, 58, article no: 2100929. https://doi.org/10.1183/13993003.00929-2021

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Last updated: 03 September 2022
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