• Damage to the lungs can lead to a puncture, causing lung collapse which is called a pneumothorax
• This is happening in about 1% of hospitalised Covid-19 patients
• Most younger patients with punctured lungs survive, but older patients are at greater risk

Punctured lungs occur in as many as one in 100 hospitalised Covid-19 patients, a new study finds.

Before the pandemic, this problem was typically seen in very tall young men or older patients with severe lung disease. But some British researchers noticed that several patients with Covid-19 developed the condition and decided to investigate.

“We started to see patients affected by a punctured lung, even among those who were not put on a ventilator,” said Stefan Marciniak, a professor at the University of Cambridge Institute of Medical Research.

“To see if this was a real association, I put a call out to respiratory colleagues across the UK via Twitter,” Marciniak said in a university news release. “The response was dramatic – this was clearly something that others in the field were seeing.”

Increased risk of death

The researchers noted that damage to the lungs can lead to a puncture. As air leaks out, it builds up in the space between the lung and chest, causing lung collapse. This is also called a pneumothorax.

For the study, Marciniak analysed data from 16 hospitals in Britain. He found that 0.91% of their Covid-19 patients had developed a punctured lung.

Of those patients with a punctured lung, 63% survived, but older patients had an increased risk of death. The survival rate among those younger than 70 was 71%, compared with 42% among those who were older, according to the study. The results are in the 9 September European Respiratory Journal.

Patients with abnormally acidic blood, called acidosis, also had poorer outcomes. Acidosis can result from poor lung function.

Diagnosis by chance

“Doctors need to be alert to the possibility of a punctured lung in patients with Covid-19, even in people who would not be thought to be typical at-risk patients,” Marciniak said.

“Many of the cases we reported were found incidentally – that is, their doctor had not suspected a punctured lung and the diagnosis was made by chance,” he noted.

The researchers said there are a number of ways that Covid-19 could lead to a punctured lung, including the formation of cysts in the lungs.

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