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. 2021 Apr-Jun;15(2):93-96.
doi: 10.4103/sja.sja_939_20. Epub 2021 Apr 1.

Spontaneous pneumomediastinum and subcutaneous emphysema in patients with COVID-19

Reema Wadhawa  1 , Avani Thakkar  1 , Heena Sunil Chhanwal  1 , Anju Bhalotra  2 , Yashpal Rana  3 , Vivek Wadhawa  4
Affiliations

Spontaneous pneumomediastinum and subcutaneous emphysema in patients with COVID-19

Reema Wadhawa et al. Saudi J Anaesth. 2021 Apr-Jun.

Abstract

Background: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-COV-2). Many aspects of its pathology and pathogenesis are not well understood.

Material and methods: We describe a series of spontaneous air leak cases we found in our coronavirus disease 2019 (COVID-19) positive 1086-patient cohort.

Results: Two out of six patients eventually required mechanical ventilation and succumbed to COVID-19. We presume that acute lung injury leading to SARS-CoV-2 with associated acute respiratory distress syndrome predisposes patients to this complication.

Conclusion: This series is presented to highlight the emerging association of COVID-19 with spontaneous air leaks leading to pneumomediastinum, pneumothorax, and subsequent subcutaneous emphysema even in patients who have never received invasive mechanical ventilation and this may be more likely with the institution of high flow nasal cannula.

Keywords: ARDS; COVID -19; SARS-COV-2.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Normal, axial image; (b) normal, coronal image; (c) mild covid, axial image, no pneumomediastinum; (d) mild covid, axial image, no pneumomediastinum; (e) coronalimage, pneumomediastinum; (f) axialimage, pneumomediastinum, minimal right pneumothorax; (g) coronal image, pneumomediastinum; (h) coronal image, minimal residual pneumomediastinum; (i) axial image, minimal residual pneumomediastinum; (j) coronal image, very minimal residual pneumomediastinum; and (k) axial image, very minimal residual pneumomediastinum
See this image and copyright information in PMC

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