Pneumomediastinum as a complication of COVID-19 pneumonia – self-experience study

Abstract

<b>Introduction:</b> Pneumomediastinum, defined as the presence of free air into the mediastinum, is a rare thoracic pathological condition. The aim of this research is to present pneumomediastinum as a complication of COVID-19 pneumonia, based on our first surveillance. <b>Materials and Methods:</b> We present three patients (hospitalized from August to December 2020) with COVID-19 pneumonia and pneumomediastinum: a 78-year-old woman and two men (aged: 58 and 75 years). The diagnosis of COVID-19 was carried out by real-time reverse transcriptive polymerase chain reaction. Pneumonia and pneumomediastinum were established by X-Ray and chest computed tomography. <b>Results:</b> The presenting woman developed pneumomediastinum on 12th day of mechanical ventilation (due to state of acute respiratory distress syndrome) with exitus on the 23rd day. For the two men, COVID-19 pneumonia was treated without intensive respiratory support [the 58-year-old man: pneumomediastinum was observed on the 16th day of coronavirus infection with exitus on the 31st day; the 75-year-old patient: pneumomediastinum developed on the 18th day and the patient was discharged after 39 days]. <b>Conclusion:</b> With this research we present a rare complication of COVID-19 pneumonia - pneumomediatinum, with two forms: without precipitating factor (spontaneous) and with precipitating factor (eg. mechanical ventilation). Due to the limited number of reported cases, the role of pneumomediastinum as a risk factor for a patient’s death in COVID-19 pneumonia is still debatable.