Pneumomediastinum complicating COVID-19: a case series

Pneumomediastinum complicating COVID-19: a case series

Background Pneumomediastinum is a rare complication of COVID-19 pneumonia, which may or may not be associated with invasive ventilatory support. Therefore, the report and findings associated with its evolution can be of great contribution in the management of this unknown disease. Case presentation...

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Published in:European journal of medical research Vol. 26; no. 1; pp. 1 - 114
Main Authors: Damous, Sérgio Henrique Bastos, dos Santos Junior, Jones Pessoa, Pezzano, Ãlvaro Vicente Alvarez, Chams, Mohamad Abdul Majid, Haritov, Nathaly, Waksman, Ricardo, Lima, Helber Vidal Gadelha, dos Santos Miranda, Jocielle, Rasslan, Roberto, Utiyama, Edivaldo Massazo
Format: Journal Article
Language:English
Published: London BioMed Central Ltd 26-09-2021
BioMed Central
BMC
Subjects:
Bacterial pneumonia
Bronchoscopy
Case Report
Coronaviruses
COVID-19
Development and progression
Dyspnea
Emphysema
Health aspects
Infections
Intensive care
Intubation
Ostomy
Pandemics
Patients
Pneumomediastinum
Pneumonia
Pneumothorax
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Tazobactam
Tracheotomy
Ventilators
Viral infections
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Summary:Background Pneumomediastinum is a rare complication of COVID-19 pneumonia, which may or may not be associated with invasive ventilatory support. Therefore, the report and findings associated with its evolution can be of great contribution in the management of this unknown disease. Case presentation Here, we present a series of four patients with severe pneumomediastinum requiring intensive care unit. These patients developed pneumomediastinum before or during orotracheal intubation (OTI) or without OTI. The four patients were three men and one woman with a mean age of 60.5 years (48-74 years). No patients had a known history of lung disease or traumatic events, except for one patient who had a history of smoking, but who was without parenchymal disease. All intubations were performed without complications. No cases of pneumomediastinum occurred after tracheostomy, and none of the patients had tomographic or bronchoscopic evidence of tracheal injury. Although the pneumomediastinum observed in our cases was apparently not related to a violation of the aerodigestive track, this complication was associated with a worse prognosis. Conclusion Pneumomediastinum is a rare complication of COVID-19 pneumonia, and the most likely etiopathogenesis is severe pulmonary involvement, which may or may not be associated with invasive ventilatory support. Future studies with a greater number of cases should elucidate the relationship of pneumomediastinum to a probable prognostic factor. Keywords: COVID-19, SARS-CoV-2, Pneumomediastinum
Bibliography:ObjectType-Case Study-2
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ISSN:2047-783X
0949-2321
2047-783X
DOI:10.1186/s40001-021-00585-9