\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{MANAGEMENT OF SPONTANEOUS PNEUMOTHORAX IN PATIENTS WITH COVID-19}



\author[1]{HAKKI ULUTAS}%
\author[2]{Muhammet Celik}%
\author[3]{Ilham Gulcek}%
\author[1]{Muhammed Kalkan}%
\author[1]{Mehmet Agar}%
\author[4]{TALAT KILIC}%
\author[1]{Emine Gulcek}%
\affil[1]{Inonu University School of Medicine}%
\affil[2]{Inonu University Faculty of Medicine Turgut Ozal Medical Center}%
\affil[3]{1University of Inonu, Faculty of Medicine, }%
\affil[4]{Inonu University Faculty of Medicine}%


\vspace{-1em}



  
  \date{May 24, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
The coronavirus diseases 2019 (COVID-19) pneumonia may cause cystic
features of lung parenchyma which can resolve or progress to larger
blebs. Spontaneous pneumothorax (SP) was reported as a complication of
COVID-19 with an incidence of 1\% in hospitalized patients, in 3\% of
patients hospitalized with pneumonia, in 6\% mechanically ventilated
patients and in 1\% of decased patients. Pneumothorax was more likely in
patients with neutrophilia, severe lung injury and a prolonged clinical
course. We present 11 cases of SP managed with chest tube thoracostomy
(CTT) or high dose oxygen therapy. Isolated SP was detected in all
cases. Eight cases were male and three cases were female. There were
bilateral ground-glass opacities or pulmonary infiltrates in the
parenchyma of the ten cases. We detected neutrophilia, lymphopenia and
increased CRP, Ferritin, LDH, D-Dimer, IL-6 levels in almost all cases.
CTT was sufficient to treat pneumothorax in our nine of case. In two
cases, pneumothorax healed with high dose oxygen therapy. Favipiravir
and antibiotic treatment were given to different ten patients. In our
institution, all patients with COVID-19 infection were placed on
prophylactic or therapeutic anticoagulation, unless contraindicated. The
treatments of patients diagnosed with secondary spontaneous pneumothorax
during the pandemic period and those diagnosed with secondary
spontaneous pneumothorax in the previous three years were compared with
the durations of tube thoracostomy performed in both groups. The
increased number of cases of pneumothorax suggests that pneumothorax may
be a complication of covid-19 infection. During medical treatment of
covid-19, pneumothorax may be the only reason for hospitalization.
Although tube thoracostomy is a sufficient treatment option in most
cases, clinicians should be aware of the difficulties that may arise in
diagnosis and treatment.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`Main .docx`  available at \url{https://authorea.com/users/471076/articles/562784-management-of-spontaneous-pneumothorax-in-patients-with-covid-19}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-1/Figure-1}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-2/Figure-2}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-3/Figure-3}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-4/Figure-4}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-5/Figure-5}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-6/Figure-6}

\end{center}
\end{figure}

\textbf{Hosted file}

\verb`Table 1.docx`  available at \url{https://authorea.com/users/471076/articles/562784-management-of-spontaneous-pneumothorax-in-patients-with-covid-19}

\textbf{Hosted file}

\verb`Table 2.docx`  available at \url{https://authorea.com/users/471076/articles/562784-management-of-spontaneous-pneumothorax-in-patients-with-covid-19}

\selectlanguage{english}
\FloatBarrier
\end{document}

