Spontaneous pneumomediastinum as a complication of a COVID-19 related pneumonia: case report and review of literature

Urigo, Carlo; Soin, Susanne; Sahu, Ajay

doi:10.1016/j.radcr.2020.09.052

Cited by 16 publications

(14 citation statements)

References 29 publications

(38 reference statements)

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“…Isolated SPM may portend a worse prognosis in patients hospitalized with COVID-19 [13][14][15]. From the combination of our cases and the patients with COVID-19 who developed isolated SPM in the literature, eight out of 31 (25.8%) patients with available data on outcome expired.…”

Section: Discussionmentioning

confidence: 72%

Isolated Spontaneous Pneumomediastinum in COVID-19 Patients: Case Series and Review of the Literature

Chen¹,

Roth²,

Thomas³

et al. 2021

J Med Imaging Case Rep

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While isolated spontaneous pneumomediastinum (SPM) is not commonly associated with viral respiratory infections, several cases of isolated SPM in the context of coronavirus disease 2019 (COVID-19) have emerged. Isolated SPM remains seldom presented in the current literature. We will present the clinical presentation and hospital course of isolated SPM in four patients hospitalized with COVID-19 who were not on mechanical ventilation. We will also review all cases from the current literature and compare these cases for similarities and possible patterns that may help elucidate risk factors for developing SPM. Increased use of high-flow oxygen in COVID-19 management may be a potential contributing factor to the SPM development. Isolated SPM can be an indicator of disease severity and worse prognosis.

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Section: Discussionmentioning

confidence: 72%

Isolated Spontaneous Pneumomediastinum in COVID-19 Patients: Case Series and Review of the Literature

Chen¹,

Roth²,

Thomas³

et al. 2021

J Med Imaging Case Rep

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show abstract

“…In COVID-19 patients, pneumomediastinum is usually associated with more challenges in patient management and poorer outcomes [ 12 ]. Still, several case reports including ours have reported spontaneous resolution of this complication in patients with COVID-19 [ 13 , 14 ]. Although the clinical behavior of pneumomediastinum is not clear in COVID-19 patients, radiologists must do their best for the early detection of findings related to the development of pneumomediastinum.…”

Section: Discussionmentioning

confidence: 80%

The Valuable Role of Imaging Modalities in the Diagnosis of the Uncommon Presentations of COVID-19: An Educative Case Series

Khaleghi

Aziz-Ahari

Rezaeian

et al. 2021

Case Reports in Medicine

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The outbreak of coronavirus disease 2019 (COVID-19) in late 2019 rapidly turned into a global pandemic. Although the symptoms of COVID-19 are mainly respiratory ones, the infection is associated with a wide range of clinical signs and symptoms. The main imaging modality in COVID-19 is lung computed tomography (CT) scanning, but the diagnosis of the vast spectrum of complications needs the application of various imaging modalities. Owing to the novelty of the disease and its presentations, its complications—particularly uncommon ones—can be easily missed. In this study, we describe some uncommon presentations of COVID-19 diagnosed by various imaging modalities. The first case presented herein was a man with respiratory distress, who transpired to suffer from pneumothorax and pneumomediastinum in addition to the usual pneumonia of COVID-19. The second patient was a hospitalized COVID-19 case, whose clinical condition suddenly deteriorated with the development of abdominal symptoms diagnosed as mesenteric ischemia by abdominal CT angiography. The third patient was a case of cardiac involvement in the COVID-19 course, detected as myocarditis by cardiac magnetic resonance imaging (MRI). The fourth and fifth cases were COVID-19-associated encephalitis whose diagnoses were established by brain MRI. COVID-19 is a multisystem disorder with a wide range of complications such as pneumothorax, pneumomediastinum, mesenteric ischemia, myocarditis, and encephalitis. Prompt diagnosis with appropriate imaging modalities can lead to adequate treatment and better survival.

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“…The prognostic significance of the development of SPM is still under investigation. A hypothesis is that, if indeed there is a correlation between the degree of alveolar damage and the presence of pneumomediastinum, then it would be more likely to occur in patients with an advanced stage of the disease with extensive pulmonary lesions and correlate with a worse outcome [ 28 , 40 ]. Actually, in the larger published case series [ 13 , 14 , 41 , 42 ] most patients with SPM had extensive lung lesions.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pneumomediastinum and COVID-19 pneumonia: Report of three cases with emphasis on CT imaging

Kalpaxi

Kalokairinou

Katseli

et al. 2021

Radiology Case Reports

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Spontaneous pneumomediastinum (SPM) is a rare complication of coronavirus disease 2019 (COVID-19). The published literature consists mainly of case reports and small case series. There are still many questions regarding the pathogenesis, the prognostic significance and the implications on patient management. In our hospital three COVID-19 patients developed SPM: one on admission at the emergency department and the other two during hospitalization. In this study we describe their clinical course and computed tomography (CT) findings. All of them had severe disease according to the total severity score on admission CT. The management of pneumomediastinum was conservative and follow-up CT showed resolution in all patients. As the correlation between extension of parenchymal lung lesions and development of pneumomediastinum is still under investigation, we highlight the importance of reporting the severity score on chest CT in order to obtain more comparable results between different studies. Furthermore, in this tragic circumstance we also had the opportunity to familiarize ourselves with the otherwise uncommon occurrence of air along the bronchovascular sheaths (Macklin effect) and evaluate the ability of CT to detect it.

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Spontaneous pneumomediastinum as a complication of a COVID-19 related pneumonia: case report and review of literature

Cited by 16 publications

References 29 publications

Isolated Spontaneous Pneumomediastinum in COVID-19 Patients: Case Series and Review of the Literature

Isolated Spontaneous Pneumomediastinum in COVID-19 Patients: Case Series and Review of the Literature

The Valuable Role of Imaging Modalities in the Diagnosis of the Uncommon Presentations of COVID-19: An Educative Case Series

Spontaneous pneumomediastinum and COVID-19 pneumonia: Report of three cases with emphasis on CT imaging

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