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1.
Am J Case Rep ; 22: e933405, 2021 Sep 04.
Article in English | MEDLINE | ID: covidwho-1395311

ABSTRACT

BACKGROUND COVID-19 caused by SARS-CoV-2 has become a global pandemic. Diagnosis is based on clinical features, nasopharyngeal swab analyzed with real-time reverse transcription-polymerase chain reaction, and computer tomography (CT) scan pathognomonic signs. The most common symptoms associated with COVID-19 include fever, coughing, and dyspnea. The main complications are acute respiratory distress syndrome, pneumonia, kidney failure, bacterial superinfections, coagulation abnormalities with thromboembolic events, sepsis, and even death. The common CT manifestations of COVID-19 are ground-glass opacities with reticular opacities and consolidations. Bilateral lung involvement can be present, especially in the posterior parts and peripheral areas. Pleural effusion, pericardial effusion, and lymphadenopathy are rarely described. Spontaneous pneumothorax and pneumomediastinum have been observed as complications in patients with SARS-CoV-2 pneumonia during mechanical ventilation or noninvasive positive pressure ventilation, as well as in patients with spontaneous breathing receiving only oxygen therapy via nasal cannula or masks. CASE REPORT We present 2 cases of pneumomediastinum with and without pneumothorax in patients with active SARS-Cov-2 infection and 1 case of spontaneous pneumothorax in a patient with a history of paucisymptomatic SARS-CoV-2 infection. In these 3 male patients, ages 78, 73, and 70 years, respectively, COVID-19 was diagnosed through nasopharyngeal sampling tests and the presence of acute respiratory distress syndrome. CONCLUSIONS Both pneumothorax and pneumomediastinum, although rare, may be complications during or after SARS-CoV-2 infection even in patients who are spontaneously breathing. The aim of this study was to describe an increasingly frequent event whose early recognition can modify the prognosis of patients.


Subject(s)
COVID-19 , Mediastinal Emphysema , Pneumothorax , Aged , COVID-19/complications , Humans , Male , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/virology , Pandemics , Pneumothorax/diagnostic imaging , Pneumothorax/virology
2.
Pan Afr Med J ; 39: 26, 2021.
Article in English | MEDLINE | ID: covidwho-1302780

ABSTRACT

The presenting symptoms and features of COVID-19 are non-specific and may be extrapulmonary complications such as thrombotic disorders but also pneumothorax, pneumomediastinum and subcutaneous emphysema; which are well-known complications of mechanical ventilation. Nevertheless, pneumothorax and/or pneumomediastinum, could complicate the course of a COVID-19 disease even in the absence of barotrauma involved. Herein, we report the case of a 55-year-old man with a previous history of erythroblastopenia due to thymoma admitted for COVID-19-related acute respiratory distress syndrome (ARDS) who simultaneously developed spontaneous tension pneumothorax, pneumomediastinum, subcutaneous emphysema and acute bilateral pulmonary embolism as presenting features of COVID-19 while on high-flow nasal cannula. This rare case highlights the importance of screening for other coexisting alternative diagnoses at the initial presentation of a patient suspected of COVID-19.


Subject(s)
COVID-19/diagnosis , Respiratory Distress Syndrome/virology , Acute Disease , COVID-19/complications , Hospitalization , Humans , Male , Mediastinal Emphysema/virology , Middle Aged , Pneumothorax/virology , Pulmonary Embolism/virology , Subcutaneous Emphysema/virology
3.
J Investig Med High Impact Case Rep ; 9: 23247096211016228, 2021.
Article in English | MEDLINE | ID: covidwho-1225749

ABSTRACT

Spontaneous pneumomediastinum is reported in patients with coronavirus disease-2019 (COVID-19) and influenza infection independently, usually associated with noninvasive and mechanical ventilation. We report a case of spontaneous pneumomediastinum in a patient with COVID-19 and influenza coinfection. A 58-year-old male admitted with shortness of breath, diagnosed with COVID-19 and influenza infection. A computed tomography angiogram showed pneumomediastinum. He was treated conservatively with 15 L of oxygen, remdesivir, convalescent plasma, and oseltamivir. The case is being reported for its uniqueness since this is the first documented case of spontaneous pneumomediastinum in COVID-19 and influenza coinfection.


Subject(s)
COVID-19/complications , Influenza, Human/complications , Mediastinal Emphysema/virology , Pneumonia, Viral/complications , Antiviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/therapy , Coinfection , Combined Modality Therapy , Drug Therapy, Combination , Humans , Immunization, Passive , Influenza, Human/diagnosis , Influenza, Human/therapy , Male , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/therapy , Middle Aged , Oxygen Inhalation Therapy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , SARS-CoV-2
4.
Pan Afr Med J ; 38: 37, 2021.
Article in English | MEDLINE | ID: covidwho-1110743

ABSTRACT

The development of spontaneous pneumomediastinum and subcutaneous emphysema are few of the rare clinical manifestations observed in coronavirus disease-19 (COVID-19) patients which are yet to be fully understood. Most cases of spontaneous pneumomediastinum arise due to factors causing high intra-alveolar pressure. Herein, we report a case of a COVID-19 positive elderly male, who presented with spontaneous pneumomediastinum and subcutaneous emphysema unrelated to high-pressure ventilatory measures, detected on chest computed tomography (CT). Despite acute medical care, the patient progressed towards a more serious clinical course. Male gender and diffuse alveolar damage caused by COVID-19 seems to be the most relevant association in this case. However, we have enlightened other possible pathological mechanisms and their association with severity index of COVID-19.


Subject(s)
COVID-19/complications , Mediastinal Emphysema/diagnostic imaging , Subcutaneous Emphysema/diagnostic imaging , COVID-19/physiopathology , Disease Progression , Humans , Male , Mediastinal Emphysema/virology , Middle Aged , Subcutaneous Emphysema/virology , Tomography, X-Ray Computed
6.
J Infect Public Health ; 14(3): 290-292, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1002795

ABSTRACT

Real-Time-reverse-transcription-Polymerase-Chain-Reaction from nasopharyngeal swabs and chest computed tomography (CT) depicting typically bilateral ground-glass opacities with a peripheral and/or posterior distribution are mandatory in the diagnosis of COVID-19. COVID-19 pneumonia may present though with atypical features such as pleural and pericardial effusions, lymphadenopathy, cavitations, and CT halo sign. In these two case-reports, COVID-19 presented as pneumothorax, pneumomediastinum and subcutaneous emphysema in critically ill patients. These disorders may require treatment or can be even self-limiting. Clinicians should be aware of their potential effects on the cardiorespiratory status of critically ill COVID-19 patients. Finally, pneumothorax can be promptly diagnosed by means of lung ultrasound. Although operator dependent, lung ultrasound is a useful bedside diagnostic tool that could alleviate the risk of cross-infection related to COVID-19 patient transport.


Subject(s)
COVID-19/complications , Mediastinal Emphysema , Pneumothorax , Subcutaneous Emphysema , Humans , Intensive Care Units , Male , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/virology , Middle Aged , Pneumothorax/diagnostic imaging , Pneumothorax/virology , Subcutaneous Emphysema/diagnostic imaging , Subcutaneous Emphysema/virology
7.
BMJ Case Rep ; 13(12)2020 Dec 12.
Article in English | MEDLINE | ID: covidwho-975664

ABSTRACT

Spontaneous pneumomediastinum (SPM) and pneumothorax (PNX) unrelated to positive pressure ventilation has been recently reported as an unusual complication in cases of severe COVID-19 pneumonia. The presumed pathophysiological mechanism is diffuse alveolar injury leading to alveolar rupture and air leak. We present a case of COVID-19 pneumonia complicated on day 13 post admission by SPM, PNX and subcutaneous emphysema in a patient with no identifiable risk factors for such complication. The patient received medical treatment for his COVID-19 infection without the use of an invasive or non-invasive ventilator. Moreover, he is a non-smoker with no lung comorbidities and never reported a cough. He was eventually discharged home in stable condition. A comprehensive literature review revealed 15 cases of SPM developing in patients with COVID-19 pneumonia.


Subject(s)
COVID-19/complications , Mediastinal Emphysema/virology , Pneumothorax/virology , Subcutaneous Emphysema/virology , COVID-19/diagnostic imaging , Humans , Male , Middle Aged , SARS-CoV-2
8.
Heart Lung ; 49(6): 679-680, 2020.
Article in English | MEDLINE | ID: covidwho-726528

ABSTRACT

Coronavirus disease 2019 (COVID-19) has posed an unparalleled challenge to the medical communities and patients worldwide. This is the third coronavirus pandemic of the decade and worst so far in terms of the number of patients affected and related deaths. Although COVID-19 is a systemic illness, the respiratory system is obvious to be involved first, and takes most of the brunt of SARS-CoV-2 infection. Common upper and lower respiratory presentations could be sore throat, consolidation, ground glass opacities, and acute respiratory distress syndrome in severe cases. Pneumothorax, pneumomediastinum are uncommon clinical findings in association with COVID-19. We hereby report a rare case of spontaneous pneumomediastinum with a synchronous pneumopericardium.


Subject(s)
Coronavirus Infections/complications , Pneumonia, Viral/complications , Pneumopericardium/virology , Betacoronavirus , COVID-19 , Humans , Male , Mediastinal Emphysema/virology , Middle Aged , Pandemics , SARS-CoV-2
10.
Clin Med (Lond) ; 20(4): e91-e92, 2020 07.
Article in English | MEDLINE | ID: covidwho-633759

ABSTRACT

A case is presented highlighting the emerging association of COVID-19 with pneumomediastinum, even in patients who have never received mechanical ventilation or positive airway pressure.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/virology , Pneumonia, Viral/complications , COVID-19 , Computed Tomography Angiography , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2
12.
Emerg Radiol ; 27(6): 727-730, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-593492

ABSTRACT

The new disease outbreak that causes atypical pneumonia named COVID-19, which started in China's Wuhan province, has quickly spread to a pandemic. Although the imaging test of choice for the initial study is plain chest radiograph, CT has proven useful in characterizing better the complications associated with this new infection. We describe the evolution of 3 patients presenting pneumomediastinum and spontaneous pneumothorax as a very rare complication of COVID-19 and their particular interest as a probable prognostic factor.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/diagnostic imaging , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/virology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , Pneumothorax/diagnostic imaging , Pneumothorax/virology , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Contrast Media , Fatal Outcome , Female , Humans , Male , Pandemics , Radiography, Thoracic , SARS-CoV-2
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