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A woman in the Netherlands had recovered from a seemingly mild COVID-19 infection when suddenly both of her lungs collapsed, according to a new report.
The 38-year-old woman went to the emergency room after experiencing shortness of breath and severe chest pain, according to the report, published on Jan.22 in The Journal of Emergency Medicine. She said her symptoms started suddenly that day and seemed to get worse.
Five weeks earlier, the woman had developed symptoms of COVID-19, including fever and muscle pain, and had tested positive for the novel coronavirus. By this time, she was able to treat her symptoms at home with acetaminophen and an inhaler. She had gone through an initial period of recovery from her illness, but then her new symptoms began.
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An x-ray in the emergency room showed she had ‘bilateral pneumothorax’, which means both of her lungs had collapsed. A collapsed lung (pneumothorax) occurs when air escapes from the lung into the space between the lung and the chest wall, which puts pressure on the lung and prevents it from expanding properly, according to the National Institutes of Health.
The condition can be caused by trauma to the chest or by certain underlying lung conditions, including chronic obstructive pulmonary disease (COPD). Patients who are placed on a ventilator are also at risk of a collapsed lung because the device can “inflate” the lung, according to the. University of Wisconsin-Madison.
But the woman’s case was unusual because she had no risk factors for the disease, and she had not been hospitalized or put on a ventilator until her lung collapse, the authors said.
Cases of lung collapse in patients with COVID-19 have already been reported, but mainly in hospitalized patients. A study of around 6,500 patients hospitalized with COVID-19 in the UK, published in September 2020 in The European Respiratory Journal, found that about 1% of these people had pneumothorax. Of the 60 patients described in the study as having a collapsed lung, most had received some type of assisted ventilation, but a third did not. Only four patients developed pneumothorax in both lungs.
The authors of the new report, from Elisabeth TweeSteden Hospital in the Netherlands, concluded that emergency physicians should be aware of pneumothorax as a possible ‘delayed complication from COVID-19’.
The cause of the woman’s lung collapse is unclear. (When doctors cannot identify the cause of a collapsed lung, it is called a “spontaneous” collapsed lung.) The authors cannot say for sure that COVID-19 caused the collapse of the woman’s lung – the timing may have been a coincidence, they said. But since the woman had no other risk factors for lung collapse, COVID-19 may have played a role. For example, the infection may have caused microscopic changes in the tissues and blood vessels in the lungs that ultimately resulted in pneumothorax, the authors said.
Doctors typically treat pneumothorax by inserting a needle-like instrument into the ribs to remove excess air from around the patient’s lungs, according to the Mayo Clinic. In the woman’s case, the doctors used this instrument to remove the air around her right lung. His left lung was not treated because only a small part of it had collapsed and his doctors believed he would likely heal on his own. Indeed, four weeks later, both of her lungs were back to their normal size and she had no further lung complications, according to the report.
Originally posted on Live Science.
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