Mental Fatigue Impairs Second Serve Accuracy in Tennis Players.

Purpose: The aim of this 2-week randomized, counterbalance and crossover study was to investigate the effect of acute mental fatigue (MF) on tennis serve performance and accuracy in tennis players. Methods: Ten male tennis players (18 ± 4 years, 1.80 ± 0.08 m; 71 ± 13 kg) were randomized to either the MF group (N = 5) that underwent an acute MF protocol or to a control (CON) group (N = 5). The MF condition consisted in a 30-min modified Stroop color word task performed before on-court serve speed test. A visual analogue scale (VAS) was used to assess the perceptions of MF and motivation toward the upcoming technical tests. Results: Reduction over baseline score of Stroop test was noted in accuracy (N < .001), but not in reaction time (N = .968) in the MF group. Increments in perceived workload were detected (N < .001) in MF group compared to CON. No differences for first and second serve speed from deuce and advantage side were observed. Increment of percentage of failed second serves from the deuce side (N = .043) in MF were detected. Conclusions: An acute MF protocol reduced tennis serve accuracy from deuce side in male tennis players. Players should avoid cognitive efforts before training sessions and matches to prevent negative effects of their technical performance.

Short intermittent taekwondo test to assess athlete's physiological and metabolic profile.

BACKGROUND: The aim of this study was to assess the effectiveness of a new Short Intermittent Taekwondo Test (SITT) in 17 black belt athletes. METHODS: Maximal oxygen uptake (V̇O2max), carbon dioxide production (V̇CO2), respiratory exchange ratio (RER), heart rate (HR), and blood lactate concentration [La]+ during treadmill cardiopulmonary exercise test (CPET) and SITT were compared. SITT started with 10 sec of all-out kicks, alternating legs, and progressively increasing 5 s on each stage until the 4th stage. After the 4th stage the participants performed 25 s of turning kicks (Dolleo chagi), on each stage until the last (10th stage). The passive recovery phase after the 4th and the 7th stage lasted 30 s. RESULTS: V̇O2max and maximal HRmax were not significantly different (P=0.85 vs. P=0.76) between tests, while RER and [La]+ were significantly higher in SITT than in CPET (P=0.002 vs. P=0.001). No difference in RPE (P=0.84) was found. A significant positive correlation between two tests for V̇O2max and HRmax was found. CONCLUSIONS: Our findings showed that SITT induces physiological responses like CPET suggesting that it can be used to assess aerobic power in national taekwondo athletes, thus helping coaches to select correctly training intensities and monitor athletes' aerobic performance along the training phases.

Failure of Digital Device Performance in Monitoring Physical Exercise in a Pilot Study in Sedentary Persons with HIV.

Digital devices have gained popularity in the last 10 years as a tool for exercise prescription, the monitoring of daily physical activity, and nutrition for the management of a health-related parameter. Therefore, the aim of this study was to assess the effectiveness of the use of digital devices to monitor exercise data in sedentary persons with HIV who exercise following an individualized activity pacing (AP) protocol on cardiorespiratory fitness body composition, blood lipid profile, and psychological parameters. Twenty-four PLWH were enrolled in an 18-week randomized, open-label, pilot AP exercise protocol. All participants were monitored by a Health Band connected to a mobile app that transmitted the data to a server. At week 3, they were randomized either in an experimental group (EG), in which an open device configuration enabled them to receive training data feedback (n = 12), or continued with no data feedback (control group, n = 12). The primary endpoint was improvement from the baseline of 15% of steady-state oxygen consumption (V˙O2) during a 6-min walking test. Technical issues occurred when pairing the health band with the app, which prevented EG participants from regularly receiving data feedback, and with data transmission to the server, which enabled only 40% monitoring of the total training days. Consequently, the study outcomes could not be compared between the two groups, and participants also lost confidence in the study. However, 19 out of 24 participants completed the AP program. Overall, only 6 (32%) improved steady-state V˙O2, with no significant changes at W18 from the baseline. Significant reductions were observed of BMI (p = 0.040), hip circumference (p = 0.027), and total-(p = 0.049) and HDL-cholesterol (p = 0.045). The failure of digital device performance substantially affected study procedures, monitoring, and participants' engagement, and likely limited the potential benefits of the AP exercise program.

The influence of anthropometric parameters in track and field curve sprint.

BACKGROUND: Poor information is available regarding real field data on the different factors that could have an influence on curve sprint and its association with anthropometric and strength parameters. METHODS: We designed a crossover pilot-study that enrolled 14 track and field athletes of 200 and 400 m (8/14 men, age: 20.5±2.3 years, height: 1.73±0.06 m; body mass: 60.5±6.2 kg) that performed randomly in two different days assessment of anthropometric parameters, jump test by squat jump (SJ) and triple hop distance (THD), performance during a 20-m curve sprint (day 1), and assessment of 1RM for right and left limb on Bulgarian split squat (BSS) (day 2). The unpaired t test and Pearson's correlation were used for data analysis. RESULTS: No statistical differences for anthropometric and strength parametric parameters between right and left lower limbs were observed. Twenty-meter curve sprints were negatively associated with body mass (P=0.0059, R=-0.7) and Body Mass Index (BMI; P=0.032, R=0.6). Moreover, a negative association was observed with SJ height (P=0.0025, R=-0.7), speed (P=0.0028; R=-0.7), strength (P=0.009, R=-0.7) and power (P=0.009, R=-0.7). Finally, 20-m curve sprint negatively correlated with right (P=0.0021, R=-0.7) and left (P<0.0001, R=-0.9) THD and 1 RM right (P=0.025, R=-0.6;) and left (P=0.0049, R=-0.7) BSS, respectively. CONCLUSIONS: This pilot study demonstrated that 20-m curve sprint was negatively associated with body mass, BMI, vertical jump performance, THD and 1RM BSS. This information could be useful to coaches and sport scientists as a reference value to improve athlete performance for 200- and 400-m athletes.

Tracheal atypical solitary carcinoid in a so called "difficult asthma": a diagnostic challenge.

This report describes the case of a 46-year-old non-smoker housewife. She presented to our attention having a diagnosis of "difficult asthma" from another center in the previous two years. She had no allergies and had not been exposed to an excessive amount of noxious stimuli. Her chronic respiratory symptoms (dyspnea on exertion with wheezing) remained uncontrolled despite maximal anti-asthmatic inhaled therapy. An HRCT scan was performed to further investigate other pulmonary diseases that mimic asthma. It revealed a pedunculated endotracheal lesion with regular borders that obstructed 90% of the tracheal lumen. The lesion was removed via rigid bronchoscopy with laser endobronchial; histological examination revealed the presence of atypical carcinoid. Atypical carcinoids are a rare subtype of neuroendocrine lung tumor that accounts for 2% of all thoracic malignancies. They frequently arise from the central airways and cause obstructive symptoms such as coughing, wheezing, chest pain, or recurrent obstructing pneumonia, which is caused by central airway obstruction. Clinical onset is gradual and characterized by non-specific symptoms, which frequently result in misdiagnosis. As a result, in a young patient with progressive dyspnea, chronic cough, and wheezing that is not responding to anti-asthmatic treatment, second-level investigations are required and may lead to a definite diagnosis, allowing the appropriate course of treatment to begin.

Update on virus-induced asthma exacerbations.

INTRODUCTION: Viral infections are common triggers for asthma exacerbation. Subjects with asthma are more susceptible to viral infections and develop more severe or long-lasting lower respiratory tract symptoms than healthy individuals owing to impaired immune responses. Of the many viruses associated with asthma exacerbation, rhinovirus (RV) is the most frequently identified virus in both adults and children. AREAS COVERED: We reviewed epidemiological and clinical links and mechanistic studies on virus-associated asthma exacerbations. We included sections on severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), the latest evidence of coronavirus disease 2019 (COVID-19) in asthma patients, and past and future searches for therapeutic and prevention targets. EXPERT OPINION: Early treatment or prevention of viral infections might significantly reduce the rate of asthma exacerbation, which is one of the key points of disease management. Although it is hypothetically possible nowadays to interfere with every step of the infectious cycle of respiratory tract viruses, vaccination development has provided some of the most encouraging results. Future research should proceed toward the development of a wider spectrum of vaccines to achieve a better quality of life for patients with asthma and to reduce the economic burden on the healthcare system.

Extracellular Vesicles (EVs) as Crucial Mediators of Cell-Cell Interaction in Asthma.

Asthma is the most common chronic respiratory disorder worldwide and accounts for a huge health and economic burden. Its incidence is rapidly increasing but, in parallel, novel personalized approaches have emerged. Indeed, the improved knowledge of cells and molecules mediating asthma pathogenesis has led to the development of targeted therapies that significantly increased our ability to treat asthma patients, especially in severe stages of disease. In such complex scenarios, extracellular vesicles (EVs i.e., anucleated particles transporting nucleic acids, cytokines, and lipids) have gained the spotlight, being considered key sensors and mediators of the mechanisms controlling cell-to-cell interplay. We will herein first revise the existing evidence, mainly by mechanistic studies in vitro and in animal models, that EV content and release is strongly influenced by the specific triggers of asthma. Current studies indicate that EVs are released by potentially all cell subtypes in the asthmatic airways, particularly by bronchial epithelial cells (with different cargoes in the apical and basolateral side) and inflammatory cells. Such studies largely suggest a pro-inflammatory and pro-remodelling role of EVs, whereas a minority of reports indicate protective effects, particularly by mesenchymal cells. The co-existence of several confounding factors-including technical pitfalls and host and environmental confounders-is still a major challenge in human studies. Technical standardization in isolating EVs from different body fluids and careful selection of patients will provide the basis for obtaining reliable results and extend their application as effective biomarkers in asthma.

The Effectiveness of Wearable Devices in Non-Communicable Diseases to Manage Physical Activity and Nutrition: Where We Are?

Wearable devices are increasingly popular in clinical and non-clinical populations as a tool for exercise prescription, monitoring of daily physical activity and nutrition, and health-related parameters management. In this regard, smart devices not only assist people in pursuing a healthier lifestyle, but also provide a constant stream of physiological and metabolic data for management of non-communicable diseases (NCDs). Although the benefits of lifestyle-based interventions (exercise and nutrition) for NCDs are well known, the potential of wearable devices to promote healthy behaviors in clinical populations is still controversial. In this narrative review, we aimed to discuss the current application of wearable devices in NCDs, highlighting their role in prescribing and monitoring daily physical activity and dietary habits in the population living with chronic diseases. None of the studies considered specifically addressed the efficacy of the use of wearable devices, and limited are those that incorporate monitoring of both physical activity and nutrition for NCDs. However, there is evidence that such devices have helped improve physical activity levels, physical fitness, body composition, and metabolic and psychological parameters. Therefore, the authors believe that the benefits obtained from the use of wearable devices are likely to translate to public health and represent one of the important tools for the development of prevention plans in everyday life and clinical practice for optimal patient management.

Nordic Walking Improves Cardiometabolic Parameters, Fitness Performance, and Quality of Life in Older Adults With Type 2 Diabetes.

OBJECTIVE: To assess the effect of Nordic walking (NW) on cardiometabolic health, physical performance, and well-being in sedentary older adults with type 2 diabetes (T2D). METHODS: Fifteen subjects with T2D (female, 5; male, 10; age, 65 ± 6.2 years [mean ± standard deviation]; body mass index, 27.3 ± 4.9 kg/m2 [mean ± standard deviation]) were enrolled in a 6-month NW training program. The fasting glucose and glycosylated hemoglobin levels, lipid profile (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), systolic blood pressure (SBP), and diastolic blood pressures were measured before and after the intervention. Participants' quality of life (Short-Form Health Survey) and physical fitness (6-minute walking test) were also evaluated. RESULTS: Compared with baseline, NW significantly improved the fasting glucose level (103.5 ± 18.5 vs 168.7 ± 37.7 mg/dL, P = .01), SBP (121.8 ± 12.2 vs 133 ± 14.4 mm Hg, P = .02), physical fitness (759.88 ± 69 vs 615.5 ± 62.6 m, P < .001), and both mental health (54.5 ± 4.4 vs 45.7 ± 5.6, P < .01) and physical health (49.8 ± 4.7 vs 40.3 ± 5.9, P < .01). The levels of glycosylated hemoglobin (6.15% ± 0.8% vs 6.4% ± 1%, P = .46), total cholesterol (162.2 ± 31.2 vs 175.5 ± 28.8 mg/dL, P = .13), low-density lipoprotein cholesterol (95.2 ± 24.2 vs 106.3 ± 32.3 mg/dL, P = .43), and triglycerides (135.5 ± 60.8 vs 127.6 ± 57.4 mg/dL, P = 0.26) improved without reaching significance. CONCLUSION: NW training improved the glycemic levels, SBP, physical fitness, and perception of quality of life in older adults with T2D. NW represents a suitable complementary strategy to improve the global health status in this population.

Effects of plyometric training on different 8-week training intensity distributions in well-trained endurance runners.

The aim of this four-armed parallel group randomized-controlled trial was to evaluate if plyometric training could have different effects on running performance and physiological adaptations depending on the training intensity distribution (TID) in an 8-week intervention in endurance athletes. Sixty well-trained male runners (age: 34 ± 6 years, relative ⩒O2peak : 69 ± 3 ml kg-1  min-1 ) were recruited and allocated to a pyramidal (PYR), pyramidal + plyometric training (PYR + PLY), polarized (POL), and polarized + plyometric training (POL + PLY) periodization. The periodization patterns were isolated manipulations of TID, while training load was kept constant. Participants were tested pre- and post-intervention for body mass, velocity at 2 and 4 mmol·L-1 of blood lactate concentration (vBLa2, vBLa4), absolute and relative ⩒O2peak and 5-km running time trial performance, counter movement jump and squat jump. There were significant group × time interactions for vBla4 (p = 0.0235), CMJ (p = 0.0234), SJ (p = 0.0168), and 5-km running time trial performance (p = 0.0035). Specifically, vBla4 and 5-km running time trial performance showed the largest post-intervention improvements in PYR + PLY (2.4% and 1.6%) and POL + PLY (2.1% and 1.8%), respectively. No significant interactions were observed for body mass, absolute and relative ⩒O2peak , peak heart rate, lactate peak and rating of perceived exertion. In conclusion, an 8-week training periodization seems to be effective in improving performance of well-trained endurance runners. Including plyometric training once a week appeared to be more efficacious in maximizing running performance improvements, independently from the TID adopted.

Differences Between Early- and Late-Onset Asthma: Role of Comorbidities in Symptom Control.

BACKGROUND: Asthma can present in early childhood or de novo in adulthood. Our understanding of the burden of comorbidities in adult asthmatic patients stratified by age at onset is incomplete. OBJECTIVES: To evaluate how different comorbidities may affect symptom control in two distinct groups of patients with early- and late-onset asthma (EOA and LOA, respectively) and to explore whether reported comorbidities are associated with lung function and inflammatory parameters. METHODS: We conducted a cross-sectional study of 175 adult asthmatic patients (aged 57.5 ± 17.1 years) recruited at our university asthma clinic. We defined EOA as asthma onset less than 12 years, and LOA as onset greater than 40 years. The primary outcome was symptom control and main comorbidities evaluated were rhinitis, gastroesophageal reflux, obesity, cardiovascular conditions, and bronchiectasis. We used multivariable regression analysis to identify potential predictors of poor control in EOA and LOA. RESULTS: Of 175 subjects, 77 had EOA (44%), 98 had LOA (56%), and comorbidities had a differential impact in the two groups. Rhinitis was more frequent in EOA (76 vs 53%; P = .02) and was associated with uncontrolled asthma (P < .001), reduced FEV1/FVC (P = .01), increased eosinophils (P = .003) and total IgE (P < .01). Conversely, in LOA, rhinitis was associated with more controlled asthma and higher FEV1/FVC (both P < .01). In EOA, only, IgE levels were directly related to blood eosinophils (r = 0.42; P <.001) and inversely to FEV1/FVC (r = -0.35; P = .002). Obesity was present in 20% of patients in both groups, but only in LOA was it associated with uncontrolled disease (P = .009), reduced FEV1/FVC (P = .009), and blood neutrophils (P = .03). In multivariable regression analysis, rhinitis in EOA and obesity in LOA were the risk factors most closely associated with poor control. Gastroesophageal reflux, cardiovascular comorbidities, and bronchiectasis did not affect control. CONCLUSIONS: Early-onset persistent asthma and late-onset asthma are distinct phenotypes with different underlying inflammatory patterns and different comorbidities affecting symptom control.

Multidimensional 3-Month Follow-Up of Severe COVID-19: Airways beyond the Parenchyma in Symptomatic Patients.

SARS-CoV-2 may lead to a large spectrum of respiratory manifestations, including pulmonary sequelae. We conducted a single-center longitudinal study of survivors from severe COVID-19 cases who underwent a chest CT during hospitalization (CTH). Three months after being discharged, these patients were evaluated by a clinical examination, pulmonary function tests and a chest-CT scan (CTFU). Sixty-two patients were enrolled. At follow-up, 27% complained of exertional dyspnoea and 12% of cough. Dyspnoeic patients had a lower forced expiratory flow (FEF)25-75 (p = 0.015), while a CT scan (p = 0.016 showed that patients with cough had a higher extent of bronchiectasis. Lung volumes and diffusion of carbon monoxide (DLCO) at follow-up were lower in patients who had been invasively ventilated, which correlated inversely with the length of hospitalization and ground-glass extension at CTH. At follow-up, 14.5% of patients had a complete radiological resolution, while 85.5% presented persistence of ground-glass opacities, and 46.7% showed fibrotic-like alterations. Residual ground-glass at CTFU was related to the length of hospitalization (r = 0.48; p = 0.0002) and to the need for mechanical ventilation or high flow oxygen (p = 0.01) during the acute phase. In conclusion, although patients at three months from discharge showed functional impairment and radiological abnormalities, which correlated with a prolonged hospital stay and need for mechanical ventilation, the persistence of respiratory symptoms was related not to parenchymal but rather to airway sequelae.

Interrelationship among thigh intermuscular adipose tissue, cross-sectional area, muscle strength, and functional mobility in older subjects.

The aim of this cross-sectional study was to investigate the association between lower limb strength, muscle mass and composition, and balance ability in elders. Thirthy-four older participants (Age: 65.6 ± 4.73 years; male = 10 and female = 24) were assessed for muscle strength (maximal isometric strength of knee extensors and one repetition maximum by leg press, the one repetition maximum [1RM]), balance and gait capacity (Mini-BESTest), body composition by whole-body dual energy x-ray absorptiometry (obtaining Appendicular Skeletal Muscle Mass Index, ASMMI), and magnetic resonance imaging of thigh to evaluate Intermuscular Adipose Tissue (IMAT) and muscle Cross Sectional Area (CSA). Positive correlations between 1RM and ASMMI (rs = 0.64, P < .0001) and thigh CSA (rs = 0.52, P = .0017), but not with thigh IMAT, were found. In addition, significant correlations between knee extensors strength and ASMMI (rs = 0.48, P = .004) and thigh CSA (rs = 0.49, P = .0033) and IMAT (rs = -0.35, P = .043) were observed, whereas no significant correlations between the Mini-BESTest with ASMMI, thigh CSA, and IMAT were observed. Lower limb strength positively correlated with appendicular muscle mass. Further, the maximal isometric strength of knee extensors negatively correlated with thigh IMAT in elderly patients, whereas the dynamic balance ability did not correlate with any of the morphological variables of the muscle (i.e., ASMMI, CSA, and IMAT). A reduced muscle size and strength could affect movement and reduce physical function in older patients. Improving the composition and size of muscle in elder subjects could reduce frailty and risk of falls.

Effects of 16 weeks of pyramidal and polarized training intensity distributions in well-trained endurance runners.

The aim of this study was to investigate the effects of four different training periodizations, based on two different training intensity distributions during a 16-week training block in well-trained endurance runners. Sixty well-trained male runners were divided into four groups. Each runner completed one of the following 16-week training interventions: a pyramidal periodization (PYR); a polarized periodization (POL); a pyramidal periodization followed by a polarized periodization (PYR â†’ POL); and a polarized periodization followed by a pyramidal periodization (POL â†’ PYR). The PYR and POL groups trained with a pyramidal or polarized distribution for 16 weeks. To allow for the change in periodization for the PYR â†’ POL and POL â†’ PYR groups, the 16-week intervention was split into two 8-week phases, starting with pyramidal or polarized distribution and then switching to the other. The periodization patterns were isolated manipulations of training intensity distribution, while training load was kept constant. Participants were tested pre-, mid- and post-intervention for body mass, velocity at 2 and 4 mmol·L-1 of blood lactate concentration (vBLa2, vBLa4), absolute and relative peak oxygen consumption ( V ˙ O 2 peak ) and 5-km running time trial performance. There were significant group × time interactions for relative V ˙ O 2 peak (p < 0.0001), vBLa2 (p < 0.0001) and vBLa4 (p < 0.0001) and 5-km running time trial performance (p = 0.0001). Specifically, participants in the PYR â†’ POL group showed the largest improvement in all these variables (~3.0% for relative V ˙ O 2 peak , ~1.7% for vBLa2, ~1.5% for vBLa4, ~1.5% for 5-km running time trial performance). No significant interactions were observed for body mass, absolute V ˙ O 2 peak , peak heart rate, lactate peak and rating of perceived exertion. Each intervention effectively improved endurance surrogates and performance in well-trained endurance runners. However, the change from pyramidal to polarized distribution maximized performance improvements, with relative V ˙ O 2 peak representing the only physiological correlate.

Agility training in volleyball.

INTRODUCTION: Volleyball is an intermittent, extremely dynamic and open-skill team sport in which players perform a variety of acyclic movements while constantly changing game situation. The purpose of this systematic review was to provide a summary of the research that has examined intervention strategies to improve agility performance in volleyball and to synthesize the tests used to evaluate agility in volleyball. EVIDENCE ACQUISITION: A systematic review was performed in PubMed, Scopus, Web of Science and Google Scholar with titles, abstracts, and full texts that were analyzed according to predefined inclusion criteria to find relevant studies. Moreover, the methodological quality of the studies selected was assessed. EVIDENCE SYNTHESIS: Twelve studies (N.=348 participants) were included. The selected studies had a methodological quality rated poor-to-moderate (average score of 3.9, range: 1 to 6). Results showed that of all the training interventions, plyometric-based training present the greatest improvement in agility (average of 7.7%). Moreover, the agility T-test was the most used test. CONCLUSIONS: Considering the poor-to-moderate methodological quality, there is a need for developing specific longitudinal and controlled studies with the aim of studying the effect of diversified training interventions on the development of agility in volleyball players.

Air Pollution Exposure Impairs Airway Epithelium IFN-ß Expression in Pre-School Children.

Introduction: Air pollution is a risk factor for respiratory infections and asthma exacerbations. We previously reported impaired Type-I and Type-III interferons (IFN-ß/λ) from airway epithelial cells of preschool children with asthma and/or atopy. In this study we analyzed the association between rhinovirus-induced IFN-ß/λ epithelial expression and acute exposure to the principal outdoor air pollutants in the same cohort. Methods: We studied 34 children (17asthmatics/17non-asthmatics) undergoing fiberoptic bronchoscopy for clinical indications. Bronchial epithelial cells were harvested by brushing, cultured and experimentally infected with Rhinovirus Type 16 (RV16). RV16-induced IFN-ß and λ expression was measured by quantitative real time PCR, as was RV16vRNA. The association between IFNs and the mean exposure to PM10, SO2 and NO2 in the day preceding bronchoscopy was evaluated using a Generalized Linear Model (GLM) with Gamma distribution. Results: Acute exposure to PM10 and NO2 was negatively associated to RV16-induced IFNß mRNA. For each increase of 1ug/m3 of NO2 we found a significative decrease of 2.3x103 IFN-ß mRNA copies and for each increase of 1ug/m3 of PM10 a significative decrease of 1x103 IFN-ß mRNA copies. No significant associations were detected between IFN-λ mRNA and NO2 nor PM10. Increasing levels of NO2 (but not PM10) were found to be associated to increased RV16 replication. Conclusions: Short-term exposure to high levels of NO2 and PM10 is associated to a reduced IFN-ß expression by the airway epithelium, which may lead to increased viral replication. These findings suggest a potential mechanism underlying the link between air pollution, viral infections and asthma exacerbations.

Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy.

Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients' outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. METHODS: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX/PNM were compared. RESULTS: Among 1213 patients, PNX and/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX/PNM showed higher in-hospital (p = 0.02) and 90-days mortality (p = 0.048), and longer hospitalization length (p = 0.002) than COVID-19 patients without PNX/PNM. At PNX/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX/PNM occurrence was associated with longer symptom length before hospital admission (p = 0.005) and lower levels of blood lymphocytes (p = 0.017). CONCLUSION: PNX/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation.