Pleural complications in patients with coronavirus disease 2019 (COVID-19): how to safely apply and follow-up with a chest tube during the pandemic?

Eur J Cardiothorac Surg. 2020 Dec 1;58(6):1216-1221. doi: 10.1093/ejcts/ezaa356.

Abstract

Objectives: Severe acute respiratory syndrome coronavirus 2, a novel coronavirus, affects mainly the pulmonary parenchyma and produces significant morbidity and mortality. During the pandemic, several complications have been shown to be associated with coronavirus disease 2019 (COVID-19). Our goal was to present a series of patients with COVID-19 who underwent chest tube placements due to the development of pleural complications and to make suggestions for the insertion and follow-up management of the chest tube.

Methods: We retrospectively collected and analysed data on patients with laboratory-confirmed COVID-19 in our hospital between 11 March and 15 May 2020. Patients from this patient group who developed pleural complications requiring chest tube insertion were included in the study.

Results: A total of 542 patients who were suspected of having COVID-19 were hospitalized. The presence of severe acute respiratory syndrome coronavirus 2 was confirmed with laboratory tests in 342 patients between 11 March and 15 May 2020 in our centre. A chest tube was used in 13 (3.8%) of these patients. A high-efficiency particulate air filter mounted double-bottle technique was used to prevent viral transmission.

Conclusions: In patients with COVID-19, the chest tube can be applied in cases with disease or treatment-related pleural complications. Our case series comprised a small group of patients, which is one of its limitations. Still, our main goal was to present our experience with patients with pleural complications and describe a new drainage technique to prevent viral transmission during chest tube application and follow-up.

Keywords: Chest tube; Coronavirus disease 2019; Pleural complication; Severe acute respiratory syndrome coronavirus 2; Tube thoracostomy.

MeSH terms

  • Aftercare / methods
  • Aged
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / therapy
  • COVID-19 / transmission
  • Chest Tubes*
  • Cross Infection / prevention & control
  • Cross Infection / transmission
  • Drainage / instrumentation*
  • Drainage / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Infection Control / instrumentation*
  • Infection Control / methods
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Male
  • Middle Aged
  • Pandemics
  • Patient Safety
  • Pleural Diseases / therapy*
  • Pleural Diseases / virology
  • Retrospective Studies
  • Treatment Outcome
  • Turkey / epidemiology