Pneumothorax is an important complication of coronavirus disease 2019 (COVID-19) [1, 2]. Based on a series of 60 individuals, we previously estimated that 0.91% of people admitted to hospital with COVID-19 develop pneumothorax [1]. Males accounted for three quarters of those affected, and patients requiring noninvasive or invasive ventilatory support appeared at elevated risk. In a separate series of ventilated patients with COVID-19, barotrauma, defined as pneumothorax or pneumomediastinum, was found to be an independent risk for death [2]. During the pandemic, treatment strategies have evolved, influenced by large randomised controlled trials and clinical experience. Following the landmark results from the RECOVERY trial [3], dexamethasone became standard of care for patients requiring supplemental oxygen. Following the first UK wave between March and June 2020, use of noninvasive respiratory support became more common [4, 5]. Such changes could plausibly alter the incidence of pneumothorax caused by COVID-19. Indeed, a recent small study reported an increase in pneumothoraces in the second wave of COVID-19 in Italy, leading to speculation that dexamethasone use might have been causal [6].

气胸是 2019 年冠状病毒病 (COVID-19) 的重要并发症 [1, 2]。基于 60 名个体的一系列数据，我们之前估计，因 COVID-19 入院的患者中有 0.91% 会出现气胸 [1]。受影响的患者中男性占四分之三，需要无创或有创通气支持的患者似乎面临较高的风险。在另一组接受机械通气的 COVID-19 患者中，气压伤（定义为气胸或纵隔气肿）被发现是独立的死亡风险 [2]。在大流行期间，受大型随机对照试验和临床经验的影响，治疗策略发生了变化。随着 RECOVERY 试验 [3] 取得里程碑式的结果，地塞米松成为需要补充氧气的患者的标准治疗方法。继 2020 年 3 月至 6 月英国第一波浪潮之后，无创呼吸支持的使用变得更加普遍 [4, 5]。这些变化可能会改变 COVID-19 引起的气胸的发生率。事实上，最近的一项小型研究报告称，意大利第二波 COVID-19 中气胸病例有所增加，这导致人们猜测地塞米松的使用可能是造成这种情况的原因 [6]。