Spontaneous pneumomediastinum in COVID-19 pneumonia: Two Cases and Review of the Literature

Abstract

Introduction: Spontaneous pneumomediastinum (PM) is a rare presentation associated with Coronavirus disease 2019 (COVID-19). Here, we report two cases presented with spontaneous PM associated with COVID-19 pneumonia.
 Case Reports:
 Case 1: A 58-year-old female patient was admitted to the Emergency Department (ED) with dyspnea, hoarseness, myalgia, and cough. A chest CT scan revealed subcutaneous emphysema, diffuse PM, bilateral diffuse areas of ground-glass opacity, and consolidations. The patient was transferred to the critical care unit. In critical intensive care, the patient developed multi-organ failure and expired on the 10th day.
 Case 2: A 34-year-old male patient admitted to the ED with dyspnea and cough. A chest CT scan revealed diffuse PM, bilateral diffuse areas of ground-glass opacity, and consolidations. The patient was transferred to the critical care unit. His progress was uneventful and he was discharged after 12 days.
 Conclusion: Patients suspected of PM should be examined closely during the differential diagnosis of chest pain, dyspnea, subcutaneous emphysema, and various lung- and heart-induced states. Patients diagnosed with spontaneous PM should be hospitalized for observation because the condition can be associated with complications, including death.