Spontaneous Pneumomediastinum in COVID-19 Unrelated to Mechanical Ventilation: A Case Report
DOI:
https://doi.org/10.3889/oamjms.2022.9283Keywords:
Pneumomediastinum, COVID-19, Pulmonary fibrosis, Barotrauma, SARS-COV-2Abstract
Background: Pneumo-mediastinum is a rare disease associated with barotrauma and uncommonly occurs in viral pneumonia. Although the underlying mechanism of the incidence of pneumo-mediastinum in COVID-19 patients is not fully understood, barotrauma is the most probable cause.
Case Report: We reported a case of a 27-years-old woman with the chief complaint was shortness of breath and diagnosed with COVID19 based on RT-PCR examination. On the sixth day after being admitted to the hospital, suddenly, the intensity of dyspnea was increased with the decrease of oxygen saturation. CT of the chest confirmed pneumomediastinum and pneumonia COVID -19. There was no improvement of symptoms after oxygen and steroid administration. Emergency thoracotomy was not performed yet, and the patient has died.
Conclusions: Although pneumomediastinum is benign disease and self-limited disease, the presents of pneumomediastinum may relate to worse outcomes in COVID19 infections.
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CDC. Coronavirus Disease (COVID-19). Available from: https:// www.who.int/emergencies/diseases/novel-coronavirus-2019. [Last accessed on 2021 Apr 22].
Ghani M, Rodriguez-Ortiz Y, Ahmad D, Pham J, Tamsukhin P, Mir P. Spontaneous pneumomediastinum in patients with SARS-Cov-2 virus (COVID-19). Chest. 2020;158(4):A1231-2. https://doi.org/10.1016/j.chest.2020.08.1121 DOI: https://doi.org/10.1016/j.chest.2020.08.1121
Wang A, Gao G, Wang S, Chen M, Qian F, Tang W, et al. Clinical characteristics and risk factors of acute respiratory distress syndrome (ARDS) in COVID-19 patients in Beijing, China: A retrospective study. Med Sci Monit. 2020;26:e925974-1. https://doi.org/10.12659/MSM.925974 PMid:32973126 DOI: https://doi.org/10.12659/MSM.925974
Kolani S, Houari N, Haloua M, Lamrani YA, Boubbou M, Serraj M, et al. Spontaneous pneumomediastinum occurring in the SARS-COV-2 infection. IDCases. 2020;21:e00806. https://doi.org/10.1016/j.idcr.2020.e00806 PMid:32395425 DOI: https://doi.org/10.1016/j.idcr.2020.e00806
Mimouni H, Diyas S, Ouachaou J, Laaribi I, Oujidi Y, Merbouh M, et al. Spontaneous pneumomediastinum associated with COVID-19 pneumonia. Case Rep Medi. 2020;2020:4969486. https://doi.org/10.1155/2020/4969486 PMid:33123202 DOI: https://doi.org/10.1155/2020/4969486
Juárez-Lloclla JP, León-Jiménez F, Urquiaga-Calderón J, Temoche-Nizama H, Bryce-Alberti M, Portmann-Baracco A, et al. Spontaneous pneumopericardium and pneumomediastinum in twelve COVID-19 patients. Arch Bronconeumol. 2021;57:86-88. https://doi.org/10.1016/j.arbres.2020.09.013 PMid:34629677 DOI: https://doi.org/10.1016/j.arbres.2020.09.013
Tucker L, Patel S, Vatsis C, Poma A, Ammar A, Nasser W, et al. Pneumothorax and pneumomediastinum secondary to COVID-19 disease unrelated to mechanical ventilation. Case Rep Crit Care. 2020;2020:6655428. https://doi.org/10.1155/2020/6655428 PMid:33299613 DOI: https://doi.org/10.1155/2020/6655428
Mohan V, Tauseen RA. Spontaneous pneumomediastinum in COVID-19. BMJ Case Rep CP. 2020;13(5):e236519. DOI: https://doi.org/10.1136/bcr-2020-236519
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020;215:108427. https://doi.org/10.1016/j.clim.2020.108427 PMid:32325252 DOI: https://doi.org/10.1016/j.clim.2020.108427
Jia HP, Look DC, Shi L, Hickey M, Pewe L, Netland J, et al. ACE2 receptor expression and severe acute respiratory syndrome coronavirus infection depend on differentiation of human airway epithelia. J Virol. 2005;79(23):14614-21. https://doi.org/10.1128/JVI.79.23.14614-14621.2005 PMid:16282461 DOI: https://doi.org/10.1128/JVI.79.23.14614-14621.2005
Brodin P. Immune determinants of COVID-19 disease presentation and severity. Nat Med. 2021;27(1):28-33. https://doi.org/10.1038/s41591-020-01202-8 PMid:33442016 DOI: https://doi.org/10.1038/s41591-020-01202-8
Wastnedge EA, Reynolds RM, Van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID-19. Physiol Rev. 2021;101(1):303-18. https://doi.org/10.1152/physrev.00024.2020 PMid:32969772 DOI: https://doi.org/10.1152/physrev.00024.2020
Avanzato VA, Matson MJ, Seifert SN, Pryce R, Williamson BN, Anzick SL, et al. Case study: Prolonged infectious SARS-CoV-2 shedding from an asymptomatic immunocompromised individual with cancer. Cell. 2020;183(7):1901-12. https://doi.org/10.1016/j.cell.2020.10.049 PMid:33248470 DOI: https://doi.org/10.1016/j.cell.2020.10.049
Acosta MA, Singer BD. Pathogenesis of COVID-19- induced ARDS: Implications for an ageing population. Eur Respir J. 2020;56(3):2002049. https://doi.org/10.1183/13993003.02049-2020 PMid:32747391 DOI: https://doi.org/10.1183/13993003.02049-2020
Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological society of North America expert consensus document on reporting chest CT findings related to COVID-19: Endorsed by the society of thoracic radiology, the American college of radiology, and RSNA. Radiology. 2020;2(2):e200152. https://doi.org/10.1148/ryct.2020200152 PMid:33778571 DOI: https://doi.org/10.1148/ryct.2020200152
Gillespie M, Flannery P, Schumann JA, Dincher N, Mills R, Can A. Crazy-paving: A computed tomographic finding of coronavirus disease 2019. Clinical Pract Cases Emerg Med. 2020;4(3):461. https://doi.org/10.5811/cpcem.2020.5.47998 PMid:32926713 DOI: https://doi.org/10.5811/cpcem.2020.5.47998
Macklin MT, Macklin CC. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditione. Medicine. 1944;23:4. DOI: https://doi.org/10.1097/00005792-194412000-00001
Yang L, Li F, Li D, Guo JJ, Yang P, Bang SJ. Clinical analysis of complications after non-invasive positive pressure ventilation and an inquiry into the respiratory treatment strategy in patients with SARS. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2004;16(5):281-3. PMid:15132792
Takada K, Matsumoto S, Hiramatsu T, Kojima E, Watanabe H, Sizu M, et al. Management of spontaneous pneumomediastinum based on clinical experience of 25 cases. Respir Med. 2008;102(9):1329-34. https://doi.org/10.1016/j.rmed.2008.03.023 PMid:18585025 DOI: https://doi.org/10.1016/j.rmed.2008.03.023
Kangas-Dick A, Gazivoda V, Ibrahim M, Sun A, Shaw JP, Brichkov I, et al. Clinical characteristics and outcome of pneumomediastinum in patients with COVID-19 pneumonia. J Laparoendosc Adv Surg Tech A. 2021;31(3):273-8. https://doi.org/10.1089/lap.2020.0692 PMid:32936034 DOI: https://doi.org/10.1089/lap.2020.0692
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Copyright (c) 2022 Noni Novisari Soeroso, Chaliza Soliha, Aziza Ghanie, Fannie Rizki Ananda (Author)
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