For meta-analysis of observational studies, comprehensive meta-analysis version-2 (CMA-3) was used. Further analysis of data from case reports was done in Statistical Package for the Social Sciences (SPSS) version 22.

The sample size, mean age, percentage of male and female, associated comorbidities, type of barotrauma, and the clinical outcomes were included for the cohort studies. Data were extracted onto a standardized form designed in Microsoft Excel to collect the pertinent information, including the first author, type of study, site of study, year of publication, age, gender, associated comorbidities, the incidence of barotrauma, type of barotrauma, cause of barotrauma, treatment modality for barotrauma, and clinical outcomes in terms of length of hospitalization, length of ICU stay, and in-hospital mortality. Discrepancies were resolved by mutual consent obtained from the third author. The first two authors individually screened published articles based on inclusion and exclusion criteria using Covidence. We have included studies (case reports, case series, cohort, and case-control studies) from the onset of the COVID-19 pandemic from December 31, 2019, up until May 4, 2021.Īll the stages of data extraction were done according to the PRISMA guideline. Thus, to fully evaluate the available data, we sought to perform this systematic review and meta-analysis. Risk factors, pathophysiology, and clinical implications of barotrauma in patients with COVID-19 are not well understood. Barotrauma has been reported among COVID-19 patients requiring invasive mechanical ventilation (IMV), non-invasive positive pressure ventilation (NIPPV), and other forms of respiratory support ranging from supplemental oxygenation by nasal cannula to heated high flow nasal cannula, , ]. Some studies have correlated COVID-19 related barotrauma with a longer length of hospitalization, longer ICU stay, and higher mortality. An increasing number of barotrauma cases have been reported with COVID-19 pneumonia in hospitalized patients. Pulmonary barotrauma refers to the spontaneous rupture of alveoli and the subsequent release or dissection of air into the various extra alveolar spaces resulting in pneumothorax, pneumomediastinum, pulmonary interstitial emphysema, pneumatocele or air cyst formation, subcutaneous emphysema, pneumopericardium, and or pneumoperitoneum.

Pulmonary barotrauma interventuons