Hong Kong singer-songwriter Khalil Fong, who died at 41, had Pneumothorax: Why respiratory conditions are on the rise post-COVID

Fans worldwide were shocked and heartbroken to learn of the untimely passing of 41-year-old Hong Kong singer-songwriter Khalil Fong. His death was publicly announced on Saturday (March 1) through a statement from his record label, Fu Music. While the exact cause of death remains unclear, it has been reported that Khalil had been battling a “relentless illness” for five years.

The Hawaiian-born Mandopop soloist, known for hits like “Love Love Love,” “Singalongsong,” and “Tour For Three,” was renowned for leading a healthy lifestyle. He adopted a vegan diet and refrained from smoking, drinking alcohol, fizzy drinks, or coffee. Despite his mindful habits, Khalil faced his share of health challenges.

In 2010, the artist, who also wrote songs for Cantopop and Mandopop stars such as Eason Chan, Jacky Cheung, Andy Lau, and A-mei, was reportedly diagnosed with pneumothorax.

According to Dr. Lim Wan Ting, a family physician at Doctor Anywhere, pneumothorax occurs when air leaks into the pleural space, causing the lung to collapse. This increased air pressure pushes on the lung, resulting in partial or complete collapse. It can be triggered by the rupture of small air-filled sacs (blebs) on the lung surface, a condition often seen in tall, thin young individuals, particularly males.

Here’s more to know about the condition.

What causes a pneumothorax? 

Pneumothorax occurs when air leaks into the pleural space, causing the lung to collapse. This air pressure pushes on the lung, causing it to collapse, either partially or completely. It can result from the rupture of small air-filled sacs (blebs) on the lung surface, often seen in tall, thin young individuals, particularly males. 

Traumatic pneumothorax is caused by blunt chest trauma, leading to lung tissue tearing. Secondary spontaneous pneumothorax occurs in patients with underlying lung diseases like COPD or cystic fibrosis, where the pneumothorax is a complication of the pre-existing condition. 

What kind of individuals are more prone to suffering from the condition (can it affect healthy/young individuals?) 

While pneumothorax is more common in people with underlying lung conditions, it can certainly affect healthy individuals, even young ones. Trauma, like a puncture or injury to the chest, can create a pathway for air to enter the pleural space. 

Certain medical procedures, like lung biopsies or ventilation, can also increase the risk. Smoking damages lung tissue, making it more prone to bleb formation and pneumothorax. 

Finally, the lower air pressure at high altitudes can lead to air expansion, which can also trigger a pneumothorax. 

How does it lead to death? 

Although pneumothorax can be life-threatening, it rarely causes death. The danger lies in the severity of the lung collapse. If a large portion of the lung collapses, it can lead to respiratory failure, where the ability to breathe is severely compromised, resulting in low blood oxygen levels. In extreme cases, severe oxygen deprivation can cause cardiac arrest. 

A rare and dangerous complication is tension pneumothorax, where air builds up in the pleural space, compressing the heart and lungs, leading to circulatory collapse. 

What are some of the symptoms and when should you seek help?

Symptoms of pneumothorax can range from mild to severe. The most common is sudden sharp chest pain, often on the affected side, which may worsen with breathing. You may also experience shortness of breath, feeling breathless or unable to catch your breath. Rapid heartbeat is another sign as your body struggles to compensate for the lack of oxygen. Bluish discoloration of the skin, especially around the lips and fingertips, called cyanosis, indicates low blood oxygen levels. A cough, dry or productive (with mucus), may also occur. 

It’s essential to seek immediate medical attention if you experience any of the following: sudden, severe chest pain; shortness of breath; rapid heartbeat; or cyanosis. 

When should I see a GP vs. a specialist? 

A stable pneumothorax can be seen and diagnosed by a GP. However, individuals who are symptomatic should be referred to the emergency department for immediate treatment. A GP can recommend initial measures like oxygen therapy, but for more severe or complicated cases, further medical intervention in the emergency department may be necessary, including procedures like chest tube insertion or surgery. 

In recent times we seem to be seeing a rise in conditions (e.g. pneumonia) that are tied to the respiratory system. Is this in any way related to COVID? 

It’s true that we have seen a surge in respiratory illnesses, including pneumonia, in recent times. While the COVID-19 pandemic has certainly played a role, it’s not the sole factor. 

Here’s a breakdown of possible reasons:

 ● Weakened immune systems: The COVID-19 pandemic, with its lockdowns and social distancing, may have led to a decrease in exposure to common respiratory viruses, resulting in a less robust immune system in some individuals, making them more susceptible to other respiratory infections.

● New variants: The emergence of new COVID-19 variants and their ability to evade immunity could contribute to a continued rise in respiratory illness. 

● Influenza and other viral infections: Seasonal flu outbreaks can also contribute to higher rates of pneumonia, especially among vulnerable populations like the elderly, young children, and those with preexisting health conditions. 

● Pollution and environmental factors: Air quality can significantly impact respiratory health. In areas with high levels of pollution or frequent wildfires, for example, fine particulate matter can irritate the lungs and increase the risk of respiratory issues such as asthma and bronchitis. 

● Increased awareness: The pandemic has heightened awareness of respiratory symptoms, leading to more testing and diagnoses of conditions like pneumonia, which may make it appear more prevalent. 

● Reduced public health measures: As public health restrictions have eased, people have returned to pre-pandemic behaviors, such as indoor gatherings, which can facilitate the spread of respiratory viruses. 

While the exact cause of the recent rise in respiratory illnesses is complex and multifactorial, it’s likely a combination of these factors rather than simply a direct result of COVID-19.