Case Series of Pneumomediastinum and Subcutaneous Emphysema in COVID-19 Patients
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Abstract
Spontaneous pneumomediastinum has been reported in association with COVID-19. Pneumomediastinum could remain elusive until computed tomogra- phy is performed. Hence, we need to be vigilant even though it generally has a benign clinical course. We presented four confirmed COVID-19 cases with typical ground glass opacity on chest radiograph. All four had the computed tomography that re- vealed pneumomediastinum, pneumothorax and subcutaneous emphysema. Only one patient had pneumomediastinum after intubation. Pneumomediastinum is a devastating finding which should be picked up as early as possible and must be excluded in COVID patients whom deteriorate quickly, as adequate time may pass before any viable intervention can be done to expedite the patients’ recovery.
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[12] Sethi SM, Ahmed AS, Hanif S, Aqeel M, Zubairi ABS. Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan. Epidemiol Infect. 2021 Jan 20;149:e37. https://doi.org/10.1017/S095026882100011X
[13] Koullias GJ, Korkolis DP, Wang XJ et al (2004) Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. Eur J Cardiothorac Surg 25(5):852–855. https://doi.org/10.1016/j.ejcts.2004.01.042.
[2] World Health Organization. WHO coronavirus disease (COVID-19) dashboard.World Health Organization, Geneva. https://covid19.who.int/
[3] Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients [published online ahead of print, 2020 Mar 14] AJR Am J Roentgenol. 2020:1–7. https:// doi.org/10.2214/AJR.20.23034
[4] Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study Yuhui Wang, Chengjun Dong, Yue Hu, Chungao Li, Qianqian Ren, Xin Zhang, Heshui Shi, and Min Zhou Radiology 2020 296:2, E55-E64. https://doi. org/10.1148/radiol.2020200843
[5] WHO Rapid Evidence Appraisal for COVID-19 Therapies Working Group, Sterne JAC, Murthy S, et al. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA. 2020;324(13):1330-1341. https://doi.org/10.1001/ jama.2020.17023
[6] Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. Eur J Cardiothorac Surg. 2004;25:852–5. https://doi.org/10.1016/ S2213-2600(20)30079-5
[7] Yang X 2020. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 8: 475–481.
[8] Chen N 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395: 507–513. https://doi. org/10.1016/S0140-6736(20)30211-7
[9] Chan JF, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to- person transmission: a study of a family cluster. Lancet. 2020 15;395(10223):514-523. https://doi.org/10.1016/S0140- 6736(20)30154-9
[10] Wang J, Su X, Zhang T, Zheng C. Spontaneous Pneumom- ediastinum: A Probable Unusual Complication of Coronavirus Disease 2019 (COVID-19) Pneumonia. Korean J Radiol. 2020;21(5):627-628. https://doi.org/10.3348/kjr.2020.0281
[11] Mohan V, Tauseen RA Spontaneous pneumomediastinum in COVID-19 BMJ Case Reports CP 2020;13:e236519. https://doi. org/10.1136/bcr-2020-236519
[12] Sethi SM, Ahmed AS, Hanif S, Aqeel M, Zubairi ABS. Subcutaneous emphysema and pneumomediastinum in patients with COVID-19 disease; case series from a tertiary care hospital in Pakistan. Epidemiol Infect. 2021 Jan 20;149:e37. https://doi.org/10.1017/S095026882100011X
[13] Koullias GJ, Korkolis DP, Wang XJ et al (2004) Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. Eur J Cardiothorac Surg 25(5):852–855. https://doi.org/10.1016/j.ejcts.2004.01.042.
| Files | ||
| Issue | Vol 7 No 3 (2022): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v7i3.11126 | |
| Keywords | ||
| Spontaneous pneumomediastinum Pneumothorax Subcutaneous emphysema COVID-19 | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Tan YP, Vijayan V, Sia KK. Case Series of Pneumomediastinum and Subcutaneous Emphysema in COVID-19 Patients. CRCP. 2022;7(3):148-157.
