Pulmonary contusion during the COVID-19 pandemic: challenges in diagnosis and treatment

Surg Today. 2020 Sep;50(9):1113-1116. doi: 10.1007/s00595-020-02081-9. Epub 2020 Jul 22.

Abstract

Managing patients with pulmonary contusion safely and effectively during the coronavirus disease 2019 (COVID-19) pandemic is challenging. This retrospective study analyzes the clinical data of 29 consecutive patients with pulmonary contusion, including two with COVID-19, at Tongji Hospital, Wuhan, China, in January and February, 2020. We analyzed the clinical manifestations, laboratory test results, computed tomography (CT) images, treatment, and clinical outcomes. The two patients with pulmonary contusion and COVID-19 had increased leukocyte and neutrophil counts, similar to the patients with pulmonary contusion alone. Interestingly, both these patients had subpleural ground glass opacity on CT images as a typical manifestation of COVID-19. All 29 patients were treated conservatively, including with closed thoracic drainage, instead of with thoracotomy. Six patients died of ARDS or craniocerebral injury, but the others stabilized. During the COVID-19 pandemic, patients with pulmonary contusion should be tested for SARS-CoV-2 and unless critical, thoracotomy should be avoided.

Keywords: COVID-19; Pulmonary contusion; Treatment.

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • China
  • Contusions / diagnostic imaging*
  • Contusions / therapy
  • Contusions / virology*
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • SARS-CoV-2
  • Young Adult