Pneumothorax and Pneumomediastinum Secondary to COVID-19 Disease Unrelated to Mechanical Ventilation

Author:

Tucker Lara1,Patel Sachin23,Vatsis Catherine1,Poma Antonia1,Ammar Ali24,Nasser Wael34,Mukkera Satyanarayana23,Vo Mai23,Khan Rumi23,Carlan Steve5ORCID

Affiliation:

1. Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA

2. Division of Critical Care Medicine, Orlando Regional Healthcare, Orlando, FL, USA

3. Department of Faculty and Academic Affairs, University of Central Florida College of Medicine, Orlando, FL, USA

4. Division of Pulmonary Diseases, Orlando Regional Healthcare, Orlando, FL, USA

5. Division of Academic Affairs and Research, Orlando Regional Healthcare, Orlando, FL, USA

Abstract

In the recent worldwide coronavirus 2019 pandemic, a notable rise in pneumomediastinum and pneumothorax complications has been witnessed in numerous mechanically ventilated patients infected with severe acute respiratory syndrome coronavirus 2. Most cases have reported these complications as barotrauma from mechanical ventilation with COVID-19 disease. We aim to report three polymerase chain reaction-confirmed COVID-19 patients who developed pneumomediastinum and pneumothorax unrelated to mechanical ventilation. We originally analyzed 800 patients with COVID-19 disease at Orlando Regional Medical Center from March 1, 2020, to July 31, 2020, of which 12 patients developed pneumomediastinum and pneumothorax in their hospital course. Interestingly, three patients developed pneumomediastinum on chest imaging prior to intubation. We present these three patients, one female and two males, ages of 42, 64, and 65, respectively, who were diagnosed with COVID-19 disease through nasopharyngeal sampling tests with acute respiratory distress syndrome. Spontaneous pneumomediastinum and pneumothorax are potential complications of COVID-19 disease in the lungs unrelated to mechanical ventilation. This is similar to previous outbreaks of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) diseases. Further investigation is needed to define the causality of pneumomediastinum in nonintubated COVID-19 patients to define the incidence of disease.

Publisher

Hindawi Limited

Subject

Critical Care and Intensive Care Medicine

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