COVID-19 Pneumonia Pneumomediastinum. Clinical Cases
https://doi.org/10.21292/2078-5658-2021-18-3-23-29
Abstract
Spontaneous pneumomediastinum is a rare complication of viral pneumonia. The prevalence of pneumomediastinum among coronavirus infection patients is unknown.
Subjects and methods. Three cases of spontaneous pneumomediastinum among the COVID-19 pneumonia patients were analyzed. The researchers investigated and compared clinical, radiological and laboratory data.
Results. According to the research results, no correlation was found between the development of pneumomediastinum and changes in values of blood laboratory tests. As well as there were no signs of correlation between drug treatment and pneumomediastinum frequency.
Conclusion: The researchers suggest that the leading cause of spontaneous pneumomediastinum is viral pneumonia-associated severe alveolar damage.
About the Authors
N. А. LestevaRussian Federation
Natalia A. Lesteva, Candidate of Medical Sciences, Head of Anesthesiology and Intensive Care Department, Senior Researcher of Research Laboratory of Neuroprotection and Neurometabolic Disorders, Polenov Neurosurgical Institute – Branch of Almazov National Medical Research Center
2, Akkuratova St., St. Petersburg, 197341
E. V. Аdieva
Russian Federation
Elena V. Аdieva, Resident Physician of Anesthesiology and Intensive Care Department
2, Akkuratova St., St. Petersburg, 197341
S. S. Lesina
Russian Federation
Svetlana S. Lesina, Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Department, Polenov Neurosurgical Institute – Branch of Almazov National Medical Research Center
2, Akkuratova St., St. Petersburg, 197341
M. I. Аibazova
Russian Federation
Medina I. Аibazova, Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Department, Polenov Neurosurgical Institute – Branch of Almazov National Medical Research Center
2, Akkuratova St., St. Petersburg, 197341
K. B. Аbramov
Russian Federation
Konstanin B. Аbramov, Candidate of Medical Sciences, Deputy Chief Physician in Treatment Activities
2, Akkuratova St., St. Petersburg, 197341
K. I. Sebelev
Russian Federation
Konstantin I. Sebelev, Doctor of Medical Sciences, Head of X-ray Diagnostics Department, Leading Researcher of Research Laboratory of CNS Pathomorphology, Polenov Neurosurgical Institute - Branch of Almazov National Medical Research Center
2, Akkuratova St., St. Petersburg, 197341
А. N. Kondratiev
Russian Federation
Anatoly N. Kondratiev, Doctor of Medical Sciences, Professor, Head of Research Laboratory of Neuroprotection and Neurometabolic Disorders, Polenov Neurosurgical Institute – Branch of Almazov National Medical Research Center
2, Akkuratova St., St. Petersburg, 197341
References
1. Pavlikova E.P., Аgapov M.А., Malakhov P.S. et al. Mediastinal emphysema is a specific complication of COVID-19 (case report). Obschaya Reanimatologiya, 2021, vol. 17, no. 2, pp. 4-15. (In Russ.) https://doi.org/10.15360/1813-9779-2021-2-4-15.
2. Chand S., Kapoor S., Orsi D. et al. COVID-19-Associated critical illness-report of the first 300 patients admitted to intensive care units at a New York City Medical Center. J. Intens. Care Med., 2020, vol. 35, no. 10, pp. 963‒970. doi: 10.1177/0885066620946692.
3. Chekkoth S.M., Supreeth R.N., Valsala N. et al. Spontaneous pneumomediastinum in H1N1 infection: uncommon complication of a common infection. J. R. Coll. Physicians. Edinb., 2019, vol. 49, no. 4, pp. 298–300. doi: 10.4997/jrcpe.2019.409.
4. Chu C.M., Leung Y.Y., Hui J.Y. et al. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur. Respir. J., 2004, vol. 23, no. 6, pp. 802–804. doi: 10.1183/09031936.04.0009640.
5. Goldman N., Ketheeswaran B., Wilson H. COVID-19-associated pneumomediastinum. Clin. Med. (London, England), vol. 20, no. 4, pp. e91–e92. doi:10.7861/clinmed.2020-0247.
6. Gorospe L., Ayala-Carbonero A., Ureña-Vacas A. et al. Spontaneous pneumomediastinum in patients with COVID-19: A case series of four patients. Archiv. Bronconeumol., 2020, vol. 56, no. 11, pp. 754–756. doi: 10.1016/j.arbres.2020.06.008.
7. Hazariwala V., Hadid H., Kirsch D. et al. Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report. J. Cardioth. Surg., 2020, vol. 15, no. 1, pp. 301. doi:10.1186/s13019-020-01308-7.
8. Janssen J., Kamps M., Joosten et al. Spontaneous pneumomediastinum in a male adult with COVID-19 pneumonia. Am. J. Emerg. Med., 2020, vol. 40, no. 228, pp. e3–228.e5. doi: 10.1016/j.ajem.2020.07.066.
9. Kaji Y., Ohara G., Kagohashi K. et al. Pneumomediastinum in a patient with Pneumocystis jirovecii pneumonia. Intern. Med., 2012, vol. 51, no. 16, pp. 2251. doi: 10.2169/internalmedicine.51.8134.
10. Kass D.A., Duggal P., Cingolani O. Obesity could shift severe COVID-19 disease to younger ages. Lancet, 2020, vol. 395 (10236), pp. 1544–1545 doi: 10.1016/S0140-673(20)31024-2.
11. Kolani S., Houari N., Haloua M. et al. Spontaneous pneumomediastinum occurring in the SARS-CoV-2 infection. IDCases, 2020, vol. 21, pp. e00806. doi: 10.1016/j.idcr.2020.e00806.
12. Korkmaz C., Ozkan R., Akay M. et al. Pneumomediastinum and subcutaneous emphysema associated with dermatomyositis. Rheumatology (Oxford), 2001, vol. 40, no. 4, pp. 476–478 doi: 10.1093/rheumatology/40.4.476.
13. Macklin M.T., Macklin C.C. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: interpretation of the clinical literature in the light of laboratory experiment. Medicine, 1944, vol. 23, no. 4, pp. 281-358.
14. Malkova A., Kudlay D., Kudryavtsev I., Starshinova A., Yablonskiy P., Shoenfeld Y. Immunogenetic Predictors of Severe COVID-19. Vaccines, 2021, 9, 211. https://doi.org/10.3390/vaccines9030211.
15. Mimouni H., Diyas S., Ouachaou J. Spontaneous pneumomediastinum associated with COVID-19 pneumonia. Case Reports Med., 2020, pp. 4969486. doi: 10.1155/2020/4969486.
16. Mohan V., Tauseen R.A. Spontaneous pneumomediastinum in COVID-19. BMJ Case Reports, 2020, vol. 13, no. 5, pp. e236519. doi: 10.1136/bcr-2020-236519.
17. Peiris J.S., Chu C.M., Cheng V.C. et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet, 2003, vol. 361 (9371), pp. 1767–1772. doi: 10.1016/s0140-6736(03)13412-5.
18. Wang J., Su X., Zhang T. et al. Spontaneous pneumomediastinum: A probable unusual complication of coronavirus disease 2019 (COVID-19) pneumonia. Korean J. Radiol., 2020, vol. 21, no. 5, pp. 627–628. doi: 10.3348/kjr.2020.0281.
19. Zhou C., Gao C., Xie Y. COVID-19 with spontaneous pneumomediastinum. Lancet Infect. Dis., vol. 20, no. 4, pp. 510. doi: 10.1016/S1473-3099(20)30156-0.
Review
For citations:
Lesteva N.А., Аdieva E.V., Lesina S.S., Аibazova M.I., Аbramov K.B., Sebelev K.I., Kondratiev А.N. COVID-19 Pneumonia Pneumomediastinum. Clinical Cases. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(3):23-29. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-3-23-29