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Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema - A Rare Form of Presentation for Severe COVID-19 Pneumonia

Published in Reports (Volume 3, Issue 2)
Received: 5 January 2023     Accepted: 15 May 2023     Published: 6 July 2023
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Abstract

Spontaneous pneumomediastinum (SPM), pneumothorax (PNX), and spontaneous subcutaneous emphysema (SCE) are rare but serious complications that can occur in severe cases of COVID-19 pneumonia. These conditions occur due to widespread damage to the alveoli, the tiny air sacs in the lungs, which can lead to alveolar rupture and air leakage. In a recent study, four cases of COVID-19 pneumonia were reported, all of whom presented with symptoms suggestive of pneumomediastinum, pneumothorax, or subcutaneous emphysema. Of these cases, three had no history of any iatrogenic intervention, meaning they had not undergone any medical procedures that could have caused these conditions. The fourth person developed pneumothorax and subcutaneous emphysema after intubation, which is the process of inserting a tube into the airway to assist with breathing. These cases highlight the importance of considering these conditions as potential complications of COVID-19 itself, as well as the potential complications of managing the disease. It is critical to monitor patients with severe COVID-19 pneumonia closely for any signs of respiratory distress or worsening symptoms, and to promptly address any complications that may arise. In conclusion, while SPM, PNX, and SCE are rare complications of COVID-19 pneumonia, healthcare providers should be aware of their potential occurrence and take appropriate measures to prevent, detect, and manage them. This is especially important in patients with severe disease or those undergoing invasive procedures. Early recognition and intervention can help prevent serious complications and improve outcomes for patients.

Published in Reports (Volume 3, Issue 2)
DOI 10.11648/j.reports.20230302.11
Page(s) 11-15
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

COVID-19, SARS-COV-2, Pneumothorax, Pneumomediastinum, Subcutaneous Emphysema

References
[1] Organization WH. Coronavirus disease (‎‎COVID-19)‎‎: weekly epidemiological update. 2020.
[2] Nikpouraghdam M, Farahani AJ, Alishiri G, Heydari S, Ebrahimnia M, Samadinia H, et al. Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in IRAN: A single center study. 2020; 127: 104378.
[3] Manna S, Wruble J, Maron SZ, Toussie D, Voutsinas N, Finkelstein M, et al. COVID-19: a multimodality review of radiologic techniques, clinical utility, and imaging features. 2020; 2 (3): e200210.
[4] Ucpinar BA, Sahin C, Yanc UJJoi, health p. Spontaneous p neumothorax and subcutaneous emphysema in COVID-19 patient: case report. 2020; 13 (6): 887-9.
[5] Akshat Agrawal KKS, Gitanjali Satapathy, Humsheer Singh Sethi, Ajay Sharawat & Dwarampudi Sindhu Reddy Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 patients—a case series. Egyptian Journal of Radiology and Nuclear Medicine volume. 2021.
[6] Sun R, Liu H, Wang XJKJoR. Mediastinal emphysema, giant bulla, and pneumothorax developed during the course of COVID-19 pneumonia. 2020; 21 (5): 541.
[7] Zhou C, Gao C, Xie Y, Xu MJTLID. COVID-19 with spontaneous pneumomediastinum. 2020; 20 (4): 510.
[8] Guo HH, Sweeney RT, Regula D, Leung ANJR. Fatal 2009 influenza A (H1N1) infection, complicated by acute respiratory distress syndrome and pulmonary interstitial emphysema. 2010; 30 (2): 327-33.
[9] Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. 2020; 395 (10223): 507-13.
[10] Wang W, Gao R, Zheng Y, Jiang LJJotm. COVID-19 with spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema. 2020; 27 (5): taaa062.
[11] Wali A, Rizzo V, Bille A, Routledge T, Chambers AJA. Pneumomediastinum following intubation in COVID-19 patients: a case series. 2020; 75 (8): 1076-81.
[12] Koullias GJ, Korkolis DP, Wang XJ, Hammond GLJEjoc-ts. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. 2004; 25 (5): 852-5.
[13] Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). 2020; 295 (1): 202-7.
[14] Abdelghany Y, Rachmasari K, Alvarez-Mulett S, Wong R, Rajwani K. Incidence and management of pneumothorax, pneumomediastinum, and subcutaneous emphysema in COVID-19. SAGE Open Med. 2022 Sep 22; 10: 20503121221124761.
[15] Büyükkarabacak Y, Pirzirenli MG, Gurz S, Abacı H, Taslak Şengül A, Çelik B, Basoğlu A. COVID-19 and pneumothorax, pneumomediastinum, subcutaneous emphysema: Analysis of risk factors. Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jan 30; 31 (1): 69-77.
Cite This Article
  • APA Style

    Hasanzadeh, S., Mehri, A., Ghazvini, K., Ataee, Z. (2023). Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema - A Rare Form of Presentation for Severe COVID-19 Pneumonia. Reports, 3(2), 11-15. https://doi.org/10.11648/j.reports.20230302.11

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    ACS Style

    Hasanzadeh, S.; Mehri, A.; Ghazvini, K.; Ataee, Z. Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema - A Rare Form of Presentation for Severe COVID-19 Pneumonia. Reports. 2023, 3(2), 11-15. doi: 10.11648/j.reports.20230302.11

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    AMA Style

    Hasanzadeh S, Mehri A, Ghazvini K, Ataee Z. Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema - A Rare Form of Presentation for Severe COVID-19 Pneumonia. Reports. 2023;3(2):11-15. doi: 10.11648/j.reports.20230302.11

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  • @article{10.11648/j.reports.20230302.11,
      author = {Sepideh Hasanzadeh and Ali Mehri and Kiarash Ghazvini and Zahra Ataee},
      title = {Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema - A Rare Form of Presentation for Severe COVID-19 Pneumonia},
      journal = {Reports},
      volume = {3},
      number = {2},
      pages = {11-15},
      doi = {10.11648/j.reports.20230302.11},
      url = {https://doi.org/10.11648/j.reports.20230302.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.reports.20230302.11},
      abstract = {Spontaneous pneumomediastinum (SPM), pneumothorax (PNX), and spontaneous subcutaneous emphysema (SCE) are rare but serious complications that can occur in severe cases of COVID-19 pneumonia. These conditions occur due to widespread damage to the alveoli, the tiny air sacs in the lungs, which can lead to alveolar rupture and air leakage. In a recent study, four cases of COVID-19 pneumonia were reported, all of whom presented with symptoms suggestive of pneumomediastinum, pneumothorax, or subcutaneous emphysema. Of these cases, three had no history of any iatrogenic intervention, meaning they had not undergone any medical procedures that could have caused these conditions. The fourth person developed pneumothorax and subcutaneous emphysema after intubation, which is the process of inserting a tube into the airway to assist with breathing. These cases highlight the importance of considering these conditions as potential complications of COVID-19 itself, as well as the potential complications of managing the disease. It is critical to monitor patients with severe COVID-19 pneumonia closely for any signs of respiratory distress or worsening symptoms, and to promptly address any complications that may arise. In conclusion, while SPM, PNX, and SCE are rare complications of COVID-19 pneumonia, healthcare providers should be aware of their potential occurrence and take appropriate measures to prevent, detect, and manage them. This is especially important in patients with severe disease or those undergoing invasive procedures. Early recognition and intervention can help prevent serious complications and improve outcomes for patients.},
     year = {2023}
    }
    

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    AU  - Sepideh Hasanzadeh
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    AB  - Spontaneous pneumomediastinum (SPM), pneumothorax (PNX), and spontaneous subcutaneous emphysema (SCE) are rare but serious complications that can occur in severe cases of COVID-19 pneumonia. These conditions occur due to widespread damage to the alveoli, the tiny air sacs in the lungs, which can lead to alveolar rupture and air leakage. In a recent study, four cases of COVID-19 pneumonia were reported, all of whom presented with symptoms suggestive of pneumomediastinum, pneumothorax, or subcutaneous emphysema. Of these cases, three had no history of any iatrogenic intervention, meaning they had not undergone any medical procedures that could have caused these conditions. The fourth person developed pneumothorax and subcutaneous emphysema after intubation, which is the process of inserting a tube into the airway to assist with breathing. These cases highlight the importance of considering these conditions as potential complications of COVID-19 itself, as well as the potential complications of managing the disease. It is critical to monitor patients with severe COVID-19 pneumonia closely for any signs of respiratory distress or worsening symptoms, and to promptly address any complications that may arise. In conclusion, while SPM, PNX, and SCE are rare complications of COVID-19 pneumonia, healthcare providers should be aware of their potential occurrence and take appropriate measures to prevent, detect, and manage them. This is especially important in patients with severe disease or those undergoing invasive procedures. Early recognition and intervention can help prevent serious complications and improve outcomes for patients.
    VL  - 3
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Author Information
  • Department of Medical Laboratory Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran; Antimicrobial Resistance Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

  • Endoscopic and Minimally Invasive Surgery Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

  • Antimicrobial Resistance Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

  • Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

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