Abstract
Spontaneous pneumomediastinum is the presence of free air around mediastinal structures and frequently associated with other forms of extra-alveolar air, such as pneumopericardium, and pneumothorax. It is an uncommon occurrence and typically presents with pleuritic chest discomfort, dyspnea, odynophagia, and neck pain. It is frequently seen following chest trauma or in patients with underlying lung or connective tissue disorders. COVID-19 infection has been linked to spontaneous pneumomediastinum. We present two case reports of pneumomediastinum in two male patients whilst being treated for COVID-19 pneumonia. In one case, the pneumomediastinum was completely spontaneous whilst in the second case it was likely secondary to high flow nasal oxygen therapy. In both cases, patients were treated conservatively, and follow-up chest imaging showed complete resolution. One should keep in mind the possibility of such complication and have a low threshold for chest imaging in patients failing to improve or have sudden deterioration.
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