This observational case-control study confirmed the occurrence of pulmonary barotrauma (PBT) in 60 out of 1095 critically ill SARS-CoV-2 infected adults, thereby portraying a high risk of PBT in these patients.

A study was performed to describe the occurrence and outcomes of coronavirus-infected patients who needed positive pressure ventilation (PPV) and ultimately develop PBT. Furthermore, the predictors and risk factors of these complications were explored to decipher the pathogenesis of the disease.

Adult hospitalized COVID-19 patients aged ≥ 18 years who received any type of PPV were included. In this retrospective analysis, patients were then stratified into groups as per the development of PBT, comprising subcutaneous emphysema, collapsed lung, and pneumomediastinum.

A review of the medical history of all the subjects was done. Demographics and lab data of the patient, surgical interventions, mechanical ventilation modes, and outcomes were all assembled and assessed.

Overall, 1095 patients were critically infected with COVID-19. Out of these, 239 patients (21.8%) received PPV. The study cohort comprised 21.3% (51 out of 239 patients) with PBT. Invasive ventilation was notably linked with reduced PBT odds, despite equal exposure to the same modes of PPV in both groups.

The PBT people were much younger. Diabetes had a protective effect on developing PBT, whereas the PO₂/FIO₂ ratio was inversely linked with greater chances of getting PBT.

Patients infected with COVID-19 are more likely to develop PBT. Invasive positive pressure ventilation but not the noninvasive procedure was linked with less PBT. Also, postponing intubation does not appear to minimize pulmonary barotrauma risk.