Spontaneous Pneumomediastinum an Unusual Complication of Covid-19 Infection in a Non-intubated Patient With Diffuse Bilateral Ground-glass Opacity: A Case Report of Progression of Disease During Self-isolation
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 11 No. 2 (2021),
15 June 2021
,
Page 32679
https://doi.org/10.32598/ijmtfm.v11i2.32679
Abstract
Background: Spontaneous pneumomediastinum or mediastinal emphysema is relatively a rare disease that occurs in viral and bacterial infections with the benign entity.
Case: The patient was a 57-year-old man who, after a week of self-isolation at home, coming to the COVID-19 triage center of the hospital with severe shortness of breath. He was admitted to the Intensive Care Unit (ICU) due to acute respiratory failure. The patient was treated as the protocol designed and respiratory support with high flow nasal oxygen and Non-Invasive Positive Pressure Ventilation (NIPPV). Spontaneous pneumomediastinum was developed during viral pneumonia infection. The known risk factors included age, male sex, and abnormal laboratory finding. All the biochemical and hematological findings such as lymphopenia, thrombocytopenia, raised CRP, LDH, and ferritin were detected in our cases. They indicate a possible prognosis for the development of acute respiratory failure and adverse clinical outcomes.
Conclusion: Spontaneous pneumomediastinum has usually a benign outcome in COVID-19 Pneumonia and its prognosis is related to background conditions in patients.
- COVID-19 infection
- Pneumomediastinum
- Mediastinal emphysema
- Pneumonia
- Forensic autopsy
How to Cite
References
Kannan S, Shaik Syed Ali P, Sheeza A, Hemalatha K. COVID-19 (Novel Coronavirus 2019): Recent trends. Eur Rev Med Pharmacol Sci. 2020; 24(4):2006-11. [DOI:10.26355/eurrev_202002_20378] [PMID]
Suess CH, Hausmann R. Gross and histopathological pulmonary findings in a COVID-19 associated death during self-isolation. Int J Legal Med. 2020; 134(4):1285-90. [DOI:10.1007/s00414-020-02319-8] [PMID] [PMCID]
Berger JR. COVID-19 and the nervous system. J Neurovirol. 2020; 26(2):143-8. [DOI:10.1007/s13365-020-00840-5] [PMID] [PMCID]
Kochi AN, Tagliari AP, Forleo GB, Fassini GM, Tondo C. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol. 2020; 31(5):1003-8. [DOI:10.1111/jce.14479] [PMID] [PMCID]
Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020; 14(3):247-50. [DOI:10.1016/j.dsx.2020.03.013] [PMID] [PMCID]
Wong SH, Lui RN, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol. 2020; 35(5):744-8. [DOI:10.1111/jgh.15047] [PMID]
Trejo-Gabriel-Galán JM. [Stroke as a complication and prognostic factor of COVID-19(Spanish)]. Neurologia. 2020; 35(5):318-22. [DOI:10.1016/j.nrl.2020.04.015] [PMID] [PMCID]
Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020; 99(7):823-9. [DOI:10.1111/aogs.13867] [PMID] [PMCID]
Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc. 2020; 83(6):521-3. [DOI:10.1097/JCMA.0000000000000319] [PMID] [PMCID]
Singhal T. A review of Coronavirus disease-2019 (COVID-19). Indian J Pediatr. 2020; 87(4):281-6. [DOI:10.1007/s12098-020-03263-6] [PMID] [PMCID]
Udugama B, Kadhiresan P, Kozlowski HN, Malekjahani A, Osborne M, Li VYC, et al. Diagnosing COVID-19: The disease and tools for detection. ACS Nano. 2020; 14(4):3822-35. [DOI:10.1021/acsnano.0c02624] [PMID] [PMCID]
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. 2020; 383(2):120-8. [DOI:10.1056/NEJMoa2015432] [PMID] [PMCID]
Wichmann D, Sperhake JP, Lütgehetmann M, Steurer S, Edler C, Heinemann A, et al. Autopsy findings and venous thromboembolism in patients with COVID-19: A prospective cohort study. Ann Intern Med. 2020; 173(4):268-77. [DOI:10.7326/M20-2003] [PMID] [PMCID]
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020; 95(7):834-47. [DOI:10.1002/ajh.25829] [PMID] [PMCID]
Dai WC, Zhang HW, Yu J, Xu HJ, Chen H, Luo SP, et al. [CT imaging and differential diagnosis of COVID-19(French)]. Can Assoc Radiol J. 2020; 71(2):195-200. [DOI:10.1177/0846537120913033] [PMID] [PMCID]
Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020; 215(1):87-93. [DOI:10.2214/AJR.20.23034] [PMID]
Li Y, Xia L. Coronavirus disease 2019 (COVID-19): Role of chest CT in diagnosis and management. AJR Am J Roentgenol. 2020; 214(6):1280-6. [DOI:10.2214/AJR.20.22954] [PMID]
Arshad H, Young M, Adurty R, Singh AC. Acute pneumothorax. Crit Care Nurs Q. 2016; 39(2):176-89.[DOI:10.1097/CNQ.0000000000000110] [PMID]
Kim D, Jung B, Jang BH, Chung SH, Lee YJ, Ha IH. Epidemiology and medical service use for spontaneous pneumothorax: A 12-year study using nationwide cohort data in Korea. BMJ Open. 2019; 9(10):e028624. [DOI:10.1136/bmjopen-2018-028624] [PMID] [PMCID]
Al-Azzawi M, Douedi S, Alshami A, Al-Saoudi G, Mikhail J. Spontaneous subcutaneous emphysema and pneumomediastinum in COVID-19 patients: An indicator of poor prognosis? Am J Case Rep. 2020; 21:e925557. [DOI:10.12659/AJCR.925557] [PMID] [PMCID]
Mohan V, Tauseen RA. Spontaneous pneumomediastinum in COVID-19. BMJ Case Rep. 2020; 13(5):e236519. [DOI:10.1136/bcr-2020-236519] [PMID] [PMCID]
López Vega JM, Parra Gordo ML, Diez Tascón A, Ossaba Vélez S. Pneumomediastinum and spontaneous pneumothorax as an extrapulmonary complication of COVID-19 disease. Emerg Radiol. 2020; 27(6):727-30. [DOI:10.1007/s10140-020-01806-0] [PMID] [PMCID]
Zhou C, Gao C, Xie Y, Xu M. COVID-19 with spontaneous pneumomediastinum. Lancet Infect Dis. 2020; 20(4):510. [DOI:10.1016/S1473-3099(20)30156-0] [PMID] [PMCID]
Wang W, Gao R, Zheng Y, Jiang L. COVID-19 with spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema. J Travel Med. 2020; 27(5):taaa062.[DOI:10.1093/jtm/taaa062] [PMID] [PMCID]
Wang J, Su X, Zhang T, Zheng C. Spontaneous pneumomediastinum: A probable unusual complication of Coronavirus disease 2019 (COVID-19) pneumonia. Korean J Radiol. 2020; 21(5):627-8. [DOI:10.3348/kjr.2020.0281] [PMID] [PMCID]
Manna S, Maron SZ, Cedillo MA, Voutsinas N, Toussie D, Finkelstein M, et al. Spontaneous subcutaneous emphysema and pneumomediastinum in non-intubated patients with COVID-19. Clin Imaging. 2020; 67:207-13. [DOI:10.1016/j.clinimag.2020.08.013] [PMID] [PMCID]
Vela Colmenero RM, de Guzmán MDPG, de la Torre MCM. [Spontaneous pneumothorax and pneumomediastinum in bilateral pneumonia due to COVID-19 (Spanish)]. Med Intensiva. 2020; 44(9):591-2. [DOI:10.1016/j.medin.2020.05.020] [PMID] [PMCID]
- Abstract Viewed: 187 times
- pdf Downloaded: 180 times