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Cases on International Business Logistics in the Middle East ; : 92-109, 2023.
Article in English | Scopus | ID: covidwho-2296032
6th International Symposium on Multidisciplinary Studies and Innovative Technologies, ISMSIT 2022 ; : 408-412, 2022.
Article in English | Scopus | ID: covidwho-2152477
Baghdad Science Journal ; 18(3):593-613, 2021.
Article in English | Scopus | ID: covidwho-1148401
2020 International Conference on Decision Aid Sciences and Application, DASA 2020 ; : 663-668, 2020.
Article in English | Scopus | ID: covidwho-1091141
Epidemiol Infect ; 149: e37, 2021 01 20.
Article in English | MEDLINE | ID: covidwho-1072077


Since December 2019, the clinical symptoms of coronavirus disease 2019 (COVID-19) and its complications are evolving. As the number of COVID patients requiring positive pressure ventilation is increasing, so is the incidence of subcutaneous emphysema (SE). We report 10 patients of COVID-19, with SE and pneumomediastinum. The mean age of the patients was 59 ± 8 years (range, 23-75). Majority of them were men (80%), and common symptoms were dyspnoea (100%), fever (80%) and cough (80%). None of them had any underlying lung disorder. All patients had acute respiratory distress syndrome on admission, with a median PaO2/FiO2 ratio of 122.5. Eight out of ten patients had spontaneous pneumomediastinum on their initial chest x-ray in the emergency department. The median duration of assisted ventilation before the development of SE was 5.5 days (interquartile range, 5-10 days). The highest positive end-expiratory pressure (PEEP) was 10 cmH2O for patients recieving invasive mechanical ventilation, while 8 cmH2O was the average PEEP in patients who had developed subcutaneous emphysema on non-invasive ventilation. All patients received corticosteroids while six also received tocilizumab, and seven received convalescent plasma therapy, respectively. Seven patients died during their hospital stay. All patients either survivor or non-survivor had prolonged hospital stay with an average of 14 days (range 8-25 days). Our findings suggest that it is lung damage secondary to inflammatory response due to COVID-19 triggered by the use of positive pressure ventilation which resulted in this complication. We conclude that the development of spontaneous pneumomediastinum and SE whenever present, is associated with poor outcome in critically ill COVID-19 ARDS patients.

COVID-19/complications , COVID-19/epidemiology , Mediastinal Emphysema/etiology , SARS-CoV-2 , Subcutaneous Emphysema/etiology , Adult , Aged , Female , Humans , Male , Mediastinal Emphysema/epidemiology , Middle Aged , Pakistan/epidemiology , Subcutaneous Emphysema/epidemiology , Tertiary Care Centers , Young Adult