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Medicina (Kaunas) ; 57(10)2021 Oct 18.
Article in English | MEDLINE | ID: covidwho-1470926


Infection with severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019 (COVID-19) which was revealed an official pandemic by the World Health Organization on 11 March 2020. The current pandemic, the third of this decade, is the worst in terms of suffering and deaths related. COVID-19 represents an unprecedented challenge for medical communities and patients around the world. High-resolution computed tomography of the chest (HRCT) is a fundamental tool in both management and diagnosis of the disease. Imaging plays an essential role in the diagnosis of all the manifestations of the disease and its complications and the correct use and interpretation of imaging tests are essential. Pneumomediastinum has been reported rarely in COVID-19 patients. We were one of the first groups to share our experiences in uncommon parenchymal complications of COVID-19 with spontaneous pneumothorax and pneumomediastinum, but also with new-onset bronchiectasis and cysts. A finding of pneumopericardium is also unusual. We hereby report a rare case of spontaneous pneumopericardium in a patient with COVID-19 pneumonia treated only with a high-flow nasal cannula (HFNC).

COVID-19 , Pneumopericardium , Cannula , Humans , Pandemics , Pneumopericardium/diagnostic imaging , Pneumopericardium/etiology , SARS-CoV-2
Am J Case Rep ; 22: e931800, 2021 Jun 16.
Article in English | MEDLINE | ID: covidwho-1271059


BACKGROUND Pneumomediastinum and pneumopericardium have been reported to occur in people who regularly smoke marijuana and have also been reported in patients with COVID-19 pneumonia due to infection with SARS-CoV-2. This report is of a 17-year-old girl with a history of marijuana use who presented with pneumomediastinum and pneumopericardium and was found to be positive for SARS-CoV-2 infection on hospital admission by Abbott ID NOW testing. CASE REPORT A 17-year-old girl presented to the emergency room with a 3-day history of abdominal pain, nausea, and vomiting and a 1-day history of diarrhea. She had a history of daily marijuana use and lived with her grandmother who was presumed to be positive for COVID-19, based on symptoms. Her admission laboratory results were unremarkable except for pyuria, which was suspicious for urinary tract infection. The patient's nasopharyngeal swab was positive for SARS-CoV-2 infection. Owing to abdominal pain, a computed tomography (CT) scan of the abdomen and pelvis was obtained, which was concerning for pneumomediastinum and pneumopericardium. A CT scan of the thorax confirmed the findings. A contrast-enhanced barium esophagogram was performed and was unremarkable. The patient was admitted to the pediatric intensive care unit for observation and supportive care. CONCLUSIONS This report shows the importance of current testing for SARS-CoV-2 infection in patients of all ages who present acutely to the hospital. It also highlights the importance of obtaining a full social and medical history so that symptoms and signs from causes other than SARS-CoV-2 infection are not missed.

COVID-19 , Marijuana Use , Mediastinal Emphysema , Pneumopericardium , Adolescent , Child , Female , Hospitals , Humans , Mediastinal Emphysema/chemically induced , Mediastinal Emphysema/diagnostic imaging , Pneumopericardium/diagnostic imaging , Pneumopericardium/etiology , SARS-CoV-2
J Cardiothorac Surg ; 15(1): 301, 2020 Oct 07.
Article in English | MEDLINE | ID: covidwho-835855


BACKGROUND: Spontaneous pneumomediastinum unrelated to mechanical ventilation is a newly described complication of COVID-19 pneumonia. The objective of this case presentation is to highlight an important complication and to explore potential predisposing risk factors and possible underlying pathophysiology of this phenomenon. CASE PRESENTATION: We present two patients with COVID-19 pneumonia complicated by spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema without positive pressure ventilation. Both patients had multiple comorbidities, received a combination of antibiotics, steroids and supportive oxygen therapy, and underwent routine laboratory workup. Both patients then developed spontaneous pneumomediastinum and ultimately required intubation and mechanical ventilation, which proved to be challenging to manage. CONCLUSIONS: Spontaneous pneumomediastinum is a serious complication of COVID-19 pneumonia, of which clinicians should be aware. Further studies are needed to determine risk factors and laboratory data predictive of development of spontaneous pneumomediastinum in COVID-19 pneumonia.

Betacoronavirus , Coronavirus Infections/complications , Mediastinal Emphysema/etiology , Pneumonia, Viral/complications , Pneumopericardium/etiology , Pneumothorax/etiology , Subcutaneous Emphysema/etiology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Humans , Intermittent Positive-Pressure Ventilation/methods , Male , Mediastinal Emphysema/diagnosis , Mediastinal Emphysema/therapy , Middle Aged , Oxygen Inhalation Therapy/methods , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pneumopericardium/diagnosis , Pneumothorax/diagnosis , Pneumothorax/therapy , Radiography, Thoracic , SARS-CoV-2 , Subcutaneous Emphysema/diagnosis , Tomography, X-Ray Computed