Spontaneous pneumomediastinum and subcutaneous emphysema in patients with COVID-19

Reema Wadhawa; Avani Thakkar; Heena Sunil Chhanwal; Anju Bhalotra; Yashpal Rana; Vivek Wadhawa

doi:10.4103/sja.sja_939_20

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ORIGINAL ARTICLE

Year : 2021 | Volume : 15 | Issue : 2 | Page : 93-96

Spontaneous pneumomediastinum and subcutaneous emphysema in patients with COVID-19

Reema Wadhawa¹, Avani Thakkar¹, Heena Sunil Chhanwal¹, Anju Bhalotra², Yashpal Rana³, Vivek Wadhawa⁴
¹ Department of Anesthesia, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
² Department of Anesthesia, Maulana Azad Medical College, Asarwa, Ahmedabad, Gujarat, India
³ Department of Radiology, U.N. Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
⁴ Department of Cardio Vascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India

Correspondence Address:
Reema Wadhawa
Department of Anesthesia, GCS Medical College, Hospital & Research Centre, Opp. D.R.M. Office, Ahmedabad - 380 025, Gujarat
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/sja.sja_939_20

Background: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-COV-2). Many aspects of its pathology and pathogenesis are not well understood. Material and Methods: We describe a series of spontaneous air leak cases we found in our coronavirus disease 2019 (COVID-19) positive 1086-patient cohort. Results: Two out of six patients eventually required mechanical ventilation and succumbed to COVID-19. We presume that acute lung injury leading to SARS-CoV-2 with associated acute respiratory distress syndrome predisposes patients to this complication. Conclusion: This series is presented to highlight the emerging association of COVID-19 with spontaneous air leaks leading to pneumomediastinum, pneumothorax, and subsequent subcutaneous emphysema even in patients who have never received invasive mechanical ventilation and this may be more likely with the institution of high flow nasal cannula.

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ARDS; COVID -19; SARS-COV-2

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