Risk factors for development of pneumothorax in patients with COVID-19 at a government health facility in North India:An exploratory case-control study

Objective:To explore risk factors for the development of pneumothorax in patients with COVID-19 during the second COVID-19 wave at a northern Indian level 2 health facility.Methods:Patients suffering from SARS-CoV-2 infection during the second wave of the COVID-19 pandemic in India(January-June 2021)at a tertiary care teaching hospital and level 2 COVID care facility were included.Cases who suffered from SARS-CoV-2 infection but did not develop pneumothorax were selected as matched controls.All details regarding demographics,clinical presentation,treatment,and outcome were recorded in a semi-structured proforma.Results:Eleven patients with COVID-19 developed pneumothorax during the study period and 40 controls were included in the study.Five cases were smokers in comparison to only two in the control group.Type 2 diabetes mellitus was the most common comorbidity among both groups.Median change in C-reactive protein overall for cases and controls were around+14.0 and-41.9 and was statistically significant.Conclusions:Inflammatory markers like C-reactive protein have significant correlations with the development of pneumothorax in COVID-19-infected patients.There is no sex predisposition to develop pneumothorax among patients with COVID-19.