@QaaliHussein1 Enormous number of chest tubes. MICU people put them in, and a lot of them.

@rbarbosa91 We’re putting them multiple times a day, even on floor patients. So much worse than before.

@QaaliHussein1 There needs to be a new term for severe covid pneumonia. Pneumonia just feels to mild for this. Bless y’all with every hole you fix and lung you reinflate. Cannot thank the docs and nurses etc enough for putting up with this crap for nearly 2 years now.

@lizmizerik I agree. What we’re seeing is more than pneumonia.

@QaaliHussein1 I seem to remember @BrendonStilesMD doing a tonne first time around? Have y'all changed ventilation strategies or do you think it's intrinsic to the pathophysiology of COVID?

@drnikkistamp @BrendonStilesMD I think it’s intrinsic to COVID pathophys. We’re seeing it patients who are not intubated as well.

@QaaliHussein1 yes. 1 tube isn't enough. Then there is more suction, 2nd tube, BL tubes and then the code (only seen 1 COVID chest tube pt make it out)

@llsquared79 Yes, this is exactly what we’re seeing.

@QaaliHussein1 Definitely a complication; I found several published case series after admitting a kid with COVID and a spontaneous PTX.

@KJPBurns We saw this complication in previous waves too. I just haven’t seen it this bad before with patients getting pneumos spontaneously, before getting on vents, and requiring multiple chest tubes.

@QaaliHussein1 Absolutely. Loads of pneumothorax and pneumomediastinum during the second #DeltaVariant wave in India. Interestingly these were not just restricted to invasive mechanical ventilation with high supports, but also those on non-invasive ventilation and even among non-ventillated.

@ashwinrajenesh Exactly! Previous waves were only in ventilated patients.

@QaaliHussein1 @Cleavon_MD My entire family has Covid. We are all vaccinated other than my 5 yo grandson. Despite masks, hand washing, and vaccinations we are all very ill except my grandson. He was the asymptomatic carrier.

@azmanrocks The ones we’re seeing are some of the worst. Loculated, recurrent, diffuse subcutaneous emphysema

@QaaliHussein1 Also seeing more active fibrosis/organizing pneumonia with severe traction bronchiectasis in the 4-6 wk post intubation range. Also more PE. What a brutal disease.

@QaaliHussein1 @Cleavon_MD Seeing it radiologically all the time

@QaaliHussein1 We started seeing this in our third wave. Like others have said, usually they end up needing more than one. I can think of two patients who ended of having 5 CT’s at one point and then they start hemorrhaging into them. It’s an awful sight to see.

@QaaliHussein1 Tons.

@QaaliHussein1 Yes. I don’t remember seeing one initially and now I’ve seen a handful in the last two weeks. #tiredRN