Clinical observation of pneumomediastinum in a case of severe COVID-19-associated pneumonia in a teenager
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Published:2022-09-23
Issue:85
Volume:
Page:108-115
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ISSN:1998-5029
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Container-title:Bulletin Physiology and Pathology of Respiration
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language:
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Short-container-title:Bûlletenʹ fiziologii i patologii dyhaniâ
Author:
Knizhnikova E. V.1, Evseeva G. P.2, Cherezov S. A.3, Adlivankina T. M.3, Telepneva R. S.2, Suprun S. V.2, Lebedko O. A.2
Affiliation:
1. Khabarovsk Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration – Research Institute of Maternity and Childhood Protection; City Clinical Hospital named after professor A.M. Voino-Yasenetsky 2. Khabarovsk Branch of Far Eastern Scientific Center of Physiology and Pathology of Respiration – Research Institute of Maternity and Childhood Protection 3. City Clinical Hospital named after professor A.M. Voino-Yasenetsky
Abstract
Aim. Demonstration of the clinical case of pneumomediastinum in a teenager with severe COVID-19- associated pneumonia.Materials and methods. The clinical case of spontaneous pneumomediastinum was presented, which was a complication of the severe course of COVID-19 pneumonia in a teenager.Results. Patient Ch., 15 years old, with obesity of the 1st degree, was admitted to the hospital of infectious diseases for patients with a COVID-19 on the 7th day of the illness in a severe condition and had complaints of an increase in body temperature to 40ºC, pronounced cough and weakness, dyspnea when walking and at rest. The PCR test for SARS-CoV-2 gave a positive result. Multispiral computed tomography showed polysegmental interstitial lesion of both lungs, which had multiple areas of “ground glass”, signs of pneumomediastinum, subcutaneous emphysema of the upper third of the chest, left-sided pleural effusion. The volume of lung tissue lesion was 50% on the right and 85% on the left. The positive effect of treatment was not observed after 2-3 days in the hospital. The condition of heavy severity continued due to intoxication syndrome, respiratory failure, inflammatory changes in lung tissue syndrome. In this regard, the patient was injected intravenously with tocilizumab (Actemra®) 400 mg. The child was released on the 20th day of hospitalization with a positive clinical effect.Conclusion. The above clinical case demonstrates that in children a novel coronavirus infection can occur not only in severe form, but also with the possible development of complications in the form of pneumomediastinum and low effectiveness of antibacterial and antiviral therapy, which required the use of humanized monoclonal antibodies (tocilizumab).
Publisher
Far Eastern Scientific Center Of Physiology and Pathology of Respiration
Reference14 articles.
1. Alexandrovich Yu.S., Alekseeva E.I., Bakradze M.D., Baranov A.A., Batysheva T.T., Vashakmadze N.D., Vershinina M.G., Vishneva E.A., Glazyrina A.A., Gordeeva O.B., Dyakonova E.Yu., Zholobova Е.S., Zabolotsky D.V., Zvereva N.N., Zelenkova I.V., Ivanov D.O., Kaytukova E.V., Karkashadze G.A., Konovalov I.V., Kruchko D.S., Kulichenko T.V., Kurbanova S.K., Levina Y.G., Lobzin Yu.V., Mazankova L.N., Margieva T.V., Namazova-Baranova L.S., Novikova Yu.Yu., Ovsyannikov D.Yu., Petryaykina E.E., Petrenko Yu.V., Petrova N.V., Prometnoy D.V., Pshenisov K.V., Revunenkov G.V., Rtishchev A.Yu., Rusinova D.S., Sayfullin M.A., Sayfullin R.F., Selimzyanova L.R., Tatochenko V.K., Tepaev R.F., Uskov A.N., Fedoseenko M.V., Fisenko A.P., Khar’kin A.V., Efendieva K.E., Yakovlev A.V. [Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children. Version 2.]. Pediatric pharmacology 2020; 17(3):187−212 (in Russian). https://doi.org/10.15690/pf.v17i3.2123 2. Evseeva G.P., Telepneva R.S., Knizhnikova E.V., Suprun S.V., Pichugina S.V., Yakovlev E.I., Galyant O.I., Kozlov V.K., Lebed’ko O.A. [COVID-19 in pediatric population]. Bûlleten' fiziologii I patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2021; (80):100–114 (in Russian). https://doi.org/10.36604/1998-5029-2021-80-100-114 3. Shekerdemian L.S., Mahmood N.R., Wolfe K.K., Riggs B.J., Ross C.E., McKiernan C.A., Heidemann S.M., Kleinman L.C., Sen A.I., Hall M.W., Priestley M.A., McGuire J.K., Boukas K., Sharron M.P., Burns J.P. Characteristics and Outcomes of Children With Coronavirus Disease 2019(COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatrics 2020; 174(9):868–873. https://doi.org/10.1001/jamapediatrics.2020.1948 4. Dong Y., Mo X., Hu Y., Qi X., Jiang F., Jiang Z., Tong S. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; 145(6):e20200702. https://doi.org/10.1542/peds.2020-0702 5. Mazankova L.N., Osmanov I.M., Samitova E.R., Malakhov A.B., Koroid V.V., Nedostoev А.A., Kaurova E.P., Kuznetsova T.A., Kulichkina O.S., Loban N.V. A teenager with a severe form of COVID-19. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2020; 65(5):58−65 (in Russian). https://doi.org/10.21508/1027-4065-2020-65-5-58-65
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