Enough literature has been published about pneumothorax, a condition where the lung is punctured and damaged either due to chest injury or scarring, says Medical Superintendent of Devadoss Hospital R. Sudhir. However, little information is available about treatment procedure when a COVID-19 patient develops it because it is pretty rare, he says.
The doctor recounts the arduous yet successful journey of treating a rare case where a 55-year-old patient from Madurai developed pneumothorax after testing positive for COVID-19. “When he came to us with a COVID-19 positive result, he was under treatment for 20-odd days. He was also on ventilator support in the beginning. However, he started recovering and was to be discharged as his COVID-19 test turned negative on the 26th day,” he said. Two days later the patient's lung collapsed due to pneumothorax. The second lung too collapsed the next day, he said.
The damaged lung gave way like a balloon, leaking air into the chest cavity, Dr. Sudhir said. “We had not encountered such a case in the past. When we consulted with other pulmonologists in different parts of the world, we recognised that this was a rare case,” he said.
Medical Director Sathish Devadoss said they inserted tubes into the chest for decompression and had the patient on ventilator support to provide oxygen. For better healing of the damaged lung, they also performed tracheostomy to provide direct ventilation to the lungs. The patient’s lung capacity improved with time and he was discharged by the 55th day, the doctor said.
“The patient’s treatment kept throwing us a number of surprises. We had to improvise to ensure that the patient does better with time. Sudden complications would develop at odd hours. When people develop pneumothorax, many go for lung transplants. We wanted to try treating the patient without a transplant in order to find a way to undo the damage,” said Dr. Sudhir.
Dr. Devadoss said they will be submitting their findings to medical journals soon so as to aid treatment for others. “The patient is recovering and has been discharged but is still dependent on oxygen support. We are continuing to provide him aid,” he added.