Your browser doesn't support javascript.
Pneumomediastinum in COVID-19: a phenotype of severe COVID-19 pneumonitis? The results of the United Kingdom (POETIC) survey.
Melhorn, James; Achaiah, Andrew; Conway, Francesca M; Thompson, Elizabeth M F; Skyllberg, Erik W; Durrant, Joseph; Hasan, Neda A; Madani, Yasser; Naran, Prasheena; Vijayakumar, Bavithra; Tate, Matthew J; Trevelyan, Gareth E; Zaki, Irfan; Doig, Catherine A; Lynch, Geraldine; Warwick, Gill; Aujayeb, Avinash; Jackson, Karl A; Iftikhar, Hina; Noble, Jonathan H; Ng, Anthony Y K C; Nugent, Mark; Evans, Philip J; Hastings, Robert A; Bellenberg, Harry R; Lawrence, Hannah; Saville, Rachel L; Johl, Nikolas T; Grey, Adam N; Ellis, Huw C; Chen, Cheng; Jones, Thomas L; Maddekar, Nadeem; Khan, Shahul Leyakathali; Muhammad, Ambreen Iqbal; Ghani, Hakim; Myint, Yadee Maung Maung; Rafique, Cecillia; Pippard, Benjamin J; Irving, Benjamin R H; Ali, Fawad; Asimba, Viola H; Azam, Aqeem; Barton, Eleanor C; Bhatnagar, Malvika; Blackburn, Matthew P; Millington, Kate J; Budhram, Nicholas J; Bunclark, Katherine L; Sapkal, Toshit P.
  • Melhorn J; Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, UK james.melhorn@ndm.ox.ac.uk.
  • Achaiah A; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, UK.
  • Conway FM; John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Thompson EMF; JM is the guarantor and takes responsibility for the integrity of the work from inception to published article.
  • Skyllberg EW; John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Durrant J; MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, UK.
  • Hasan NA; Royal Brompton Hospital, National Heart and Lung Institute, London, UK.
  • Madani Y; St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
  • Naran P; Newham University Hospital, Barts Health NHS Trust, London, UK.
  • Vijayakumar B; Newham University Hospital, Barts Health NHS Trust, London, UK.
  • Tate MJ; Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.
  • Trevelyan GE; Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.
  • Zaki I; Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK.
  • Doig CA; Royal Brompton Hospital, National Heart and Lung Institute, London, UK.
  • Lynch G; Chelsea and Westminster Hospital, National Heart and Lung Institute, Imperial College London, UK.
  • Warwick G; Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK.
  • Aujayeb A; Royal Berkshire Hospital, Royal Berkshire NHS Foundation Trust, Reading, UK.
  • Jackson KA; Royal Berkshire Hospital, Royal Berkshire NHS Foundation Trust, Reading, UK.
  • Iftikhar H; Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend, UK.
  • Noble JH; Prince of Wales Hospital, Cwm Taf Morgannwg University Health Board, Bridgend, Wales, UK.
  • Ng AYKC; The Royal Gwent Hospital, Aneurin Bevan Health Board, Newport, Wales, UK.
  • Nugent M; Northumbria Specialist Emergency Care Hospital, Northumbria Healthcare NHS Foundation Trust, Cramlington, UK.
  • Evans PJ; Northumbria Specialist Emergency Care Hospital, Northumbria Healthcare NHS Foundation Trust, Cramlington, UK.
  • Hastings RA; Gloucester Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
  • Bellenberg HR; Gloucester Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
  • Lawrence H; Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.
  • Saville RL; Glangwilli General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK.
  • Johl NT; Glangwilli General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK.
  • Grey AN; Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
  • Ellis HC; Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
  • Chen C; Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.
  • Jones TL; Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.
  • Maddekar N; University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, Wales, UK.
  • Khan SL; University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, Wales, UK.
  • Muhammad AI; Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville, UK.
  • Ghani H; Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville, UK.
  • Myint YMM; Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
  • Rafique C; Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke, UK.
  • Pippard BJ; Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke, UK.
  • Irving BRH; Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, UK.
  • Ali F; Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, UK.
  • Asimba VH; Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, UK.
  • Azam A; University Hospital of North Tees, North Tees and Hartlepool NHS Foundation Trust, Hartlepool, UK.
  • Barton EC; University Hospital of North Tees, North Tees and Hartlepool NHS Foundation Trust, Hartlepool, UK.
  • Bhatnagar M; Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, UK.
  • Blackburn MP; Bedford Hospital, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK.
  • Millington KJ; Nottingham University Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Budhram NJ; Royal Blackburn Teaching Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK.
  • Bunclark KL; The Grange University Hospital, Aneurin Bevan Health Board, Cwmbran, Wales, UK.
  • Sapkal TP; Darlington Memorial Hospital, County Durham and Darlington NHS Foundation Trust, Durham, UK.
Eur Respir J ; 2022 May 12.
Article in English | MEDLINE | ID: covidwho-2009349
ABSTRACT

BACKGROUND:

There is an emerging understanding that coronavirus disease 2019 (COVID-19) is associated with increased incidence of pneumomediastinum. We aimed to determine its incidence among patients hospitalised with COVID-19 in the United Kingdom and describe factors associated with outcome.

METHODS:

A structured survey of pneumomediastinum and its incidence was conducted from September 2020 to February 2021. United Kingdom-wide participation was solicited via respiratory research networks. Identified patients had SARS-CoV-2 infection and radiologically proven pneumomediastinum. The primary outcomes were to determine incidence of pneumomediastinum in COVID-19 and to investigate risk factors associated with patient mortality.

RESULTS:

377 cases of pneumomediastinum in COVID-19 were identified from 58 484 inpatients with COVID-19 at 53 hospitals during the study period, giving an incidence of 0.64%. Overall 120-day mortality in COVID-19 pneumomediastinum was 195/377 (51.7%). Pneumomediastinum in COVID-19 was associated with high rates of mechanical ventilation. 172/377 patients (45.6%) were mechanically ventilated at the point of diagnosis. Mechanical ventilation was the most important predictor of mortality in COVID-19 pneumomediastinum at the time of diagnosis and thereafter (p<0.001) along with increasing age (p<0.01) and diabetes mellitus (p=0.08). Switching patients from continuous positive airways pressure support to oxygen or high flow nasal oxygen after the diagnosis of pneumomediastinum was not associated with difference in mortality.

CONCLUSIONS:

Pneumomediastinum appears to be a marker of severe COVID-19 pneumonitis. The majority of patients in whom pneumomediastinum was identified had not been mechanically ventilated at the point of diagnosis.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Qualitative research Language: English Year: 2022 Document Type: Article Affiliation country: 13993003.02522-2021

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Qualitative research Language: English Year: 2022 Document Type: Article Affiliation country: 13993003.02522-2021