Bilateral Spontaneous Pneumothorax in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19

Introduction: Spontaneous pneumothorax is a rare complication of coronavirus disease 2019 (COVID-19), primarily reported in adults. Pediatric cases with bilateral pneumothorax are much less reported. Case Presentation: We presented the case of a five-year-old previously healthy boy who developed persistent fever, abdominal pain, generalized maculopapular rash, and dyspnea before admission. His chest computed tomography (CT) showed a viral involvement pattern of pneumonia suggestive of COVID-19. Subsequently, he was confirmed with multisystem inflammatory syndrome in children (MIS-C). While he responded well to the therapies, on the fifth day of admission, he developed respiratory distress again. A chest roentgenogram showed bilateral spontaneous pneumothorax. Bilateral chest tubes were inserted, and his condition improved sig-nificantly after five days of admission to the intensive care unit. Two weeks later, he was discharged in good condition. Conclusion(s): Children with MIS-C associated with COVID-19 may develop primary spontaneous pneumothorax. Owing to the clinical picture overlapping with MIS-C associated with COVID-19, the timely diagnosis of pneumothorax may be challenging in such patients.Copyright © 2022, Author(s).

Characteristics of Computerized Tomography (CT) Scan in COVID-19 Patients and Their Relationship with Mortality Rate

Background: This study aimed to evaluate the demographic features in patients with Coronavirus Disease-2019 (COVID-19) and to determine the relationship between Computerized Tomography (CT) and mortality. Objectives: This study aims to evaluate the characteristics for diagnosis and severity of involvement in primary imaging, their adaptation to the course of the disease, and their relationship with mortality. Methods: This retrospective study was conducted on the medical records of 212 patients with suspected COVID-19 admitted to the teaching hospitals of Shiraz University of Medical Sciences from February 20, 2009 to August 2020. The patients’ CT images were also assessed and the frequency of abnormalities was determined. Results: The Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test was positive in 204 patients (99%). Consolidation was observed in all the 206 patients. The highest degree of lung involvement (90%) was observed in 69 patients (33.5%). Atoll sign was also diagnosed in 121 cases (58.7%). Besides, crazy-paving reticular lines, subpleural sparing, and bronchial distortion were observed in 129 (62.6%), 88 (42.7%), and 124 patients (60.2%), respectively. In addition, multi-segment was detected in the CT scan results of 194 cases (94.2%), which was higher compared to the single segment seen in 12 patients (5.8%). Conclusion: CT scan is a relatively sensitive technique for diagnosing COVID-19. The study results revealed a significant relationship between CT scan and death. The disease severity was also accurate using this method.