In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 3 ( 2023-3-15), p. e0282868-
Abstract:
Barotrauma frequently occurs in coronavirus disease 2019. Previous studies have reported barotrauma to be a mortality-risk factor; however, its time-dependent nature and pathophysiology are not elucidated. To investigate the time-dependent characteristics and the etiology of coronavirus disease 2019-related-barotrauma. Methods and findings We retrospectively reviewed intubated patients with coronavirus disease 2019 from March 2020 to May 2021. We compared the 90-day survival between the barotrauma and non-barotrauma groups and performed landmark analyses on days 7, 14, 21, and 28. Barotrauma within seven days before the landmark was defined as the exposure. Additionally, we evaluated surgically treated cases of coronavirus disease 2019-related pneumothorax. We included 192 patients. Barotrauma developed in 44 patients (22.9%). The barotrauma group’s 90-day survival rate was significantly worse (47.7% vs. 82.4%, p 〈 0.001). In the 7-day landmark analysis, there was no significant difference (75.0% vs. 75.7%, p = 0.79). Contrastingly, in the 14-, 21-, and 28-day landmark analyses, the barotrauma group’s survival rates were significantly worse (14-day: 41.7% vs. 69.1%, p = 0.044; 21-day: 16.7% vs. 62.5%, p = 0.014; 28-day: 20.0% vs. 66.7%, p = 0.018). Pathological examination revealed a subpleural hematoma and pulmonary cyst with heterogenous lung inflammation. Conclusions Barotrauma was a poor prognostic factor for coronavirus disease 2019, especially in the late phase. Heterogenous inflammation may be a key finding in its mechanism. Barotrauma is a potentially important sign of lung destruction.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0282868
DOI:
10.1371/journal.pone.0282868.g001
DOI:
10.1371/journal.pone.0282868.g002
DOI:
10.1371/journal.pone.0282868.g003
DOI:
10.1371/journal.pone.0282868.g004
DOI:
10.1371/journal.pone.0282868.g005
DOI:
10.1371/journal.pone.0282868.t001
DOI:
10.1371/journal.pone.0282868.t002
DOI:
10.1371/journal.pone.0282868.t003
DOI:
10.1371/journal.pone.0282868.t004
DOI:
10.1371/journal.pone.0282868.t005
DOI:
10.1371/journal.pone.0282868.t006
DOI:
10.1371/journal.pone.0282868.s001
DOI:
10.1371/journal.pone.0282868.s002
DOI:
10.1371/journal.pone.0282868.s003
DOI:
10.1371/journal.pone.0282868.s004
DOI:
10.1371/journal.pone.0282868.s005
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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