In a new study, researchers found as many as one in 100 patients admitted to hospital with COVID-19 develop a pneumothorax—a ‘punctured lung’.
The research was conducted by a team at Cambridge University and elsewhere.
Like the inner tube of a bicycle or car tire, damage to the lungs can lead to a puncture.
As air leaks out, it builds up in the cavity between the lung and chest wall, causing the lung to collapse.
Known as a pneumothorax, this condition typically affects very tall young men or older patients with severe underlying lung disease.
During the pandemic, the team observed several patients with COVID-19 who had developed punctured lungs, even though they did not fall into either of these two categories.
They started to see patients affected by a punctured lung, even among those who were not put on a ventilator.
Although the team is unable to provide an accurate estimate of the incidence of the punctured lung in COVID-19, admissions data from the 16 hospitals participating in the study revealed an incidence of 0.91%.
Just under two-thirds (63%) of patients with a punctured lung survived.
People younger than 70 years tended to survive well, but older age was linked to a poor outcome—a 71% survival rate among under 70s patients compared with 42% among older patients.
Patients with a punctured lung were three times more likely to be male than females, though this may be accounted for by the fact that large studies of patients with COVID-19 suggest that men are more commonly affected by severe forms of the disease.
However, the survival rate did not differ between the sexes.
Patients who had abnormally acidic blood, a condition known as acidosis that can result from poor lung function, also had poorer outcomes in COVID-19 pneumothorax.
The team says although a punctured lung is a very serious condition, COVID-19 patients younger than 70 tend to respond very well to treatment.
Older patients or those with abnormally acidic blood are at greater risk of death and may therefore need more specialist care.
The team says doctors need to be alert to the possibility of a punctured lung in patients with COVID-19, even in people who would not be thought to be typical at-risk patients.
There may be several ways that COVID-19 leads to a punctured lung. These include the formation of cysts in the lungs, which has previously been observed in X-rays and CT scans.
One author of the study is Professor Stefan Marciniak from the Cambridge Institute of Medical Research.
The study is published in the European Respiratory Journal.
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