The finding of subcutaneous emphysema on chest X-rays of COVID-19 patients at Prof. Dr. I.G.N.G Ngoerah General Hospital

Abstract

Introduction: Spontaneous subcutaneous emphysema without any invasive medical procedure was a rare and severe complication related to COVID-19 infection. Extensive alveolar damage caused by COVID-19 infection and sudden increase in intrathoracic pressure by cough mechanism were some of the risk factors underlying this event. Unlike the physical examination that could be performed only with limitation, mobile chest X-RAY as one of the imaging modalities was useful and plays an important role in supporting the diagnosis of COVID-19 infection and lung-related complications such as pneumothorax, pneumomediastinum, and subcutaneous emphysema.. Thus, the purpose of this study is to evaluate the findings of subcutaneous emphysema from chest X-rays in COVID-19 patients Methods: The research design was descriptive quantitative which was conducted on May - Sep 2023 at the radiology Department of Prof. Dr. I.G.N.G Ngoerah General Hospital. The target population was all positive confirmed COVID-19 patients who had chest x-rays at Prof. Dr. I.G.N.G Ngoerah General Hospital. The data was collected from secondary sources from SIMARS and PACS and then tabulated and analyzed for gender, PCR results, age, vaccine status, and chest X-RAY findings for all samples. All of the data was analyzed with the SPSS. Result: There were 40 cases collected for COVID-19. Most samples aged were more than 59 years old (42,5%). The mortality rate was 82,5%. with subcutaneous emphysema, 1,08% of all COVID-19 cases. 40% of which was followed by pneumomediastinum, 22,5% by pneumopericardium, and 15% by pneumothorax. The most subcutaneous emphysema region findings were at supraclavicular 88% and anterior cervical 83%. Iatrogenic subcutaneous emphysema is mostly caused by the usage of medical devices (82%). Conclusion: Subcutaneous emphysema was a rare complication of severe COVID-19. Subcutaneous emphysema could be life-threatening if followed by pneumocytes, esophageal rupture, and infection or necrosis.