Covid-19 pneumonia: Timing of pneumomediastinum and pneumothorax in 11 patients

Mostafa Al Turk, Maria Mitri, Kawthar Jarrah, Joanna Abi Chebl, Georges Juvelekian


Purpose: As the pandemic continues, many complications, previously recognized as rare, are now being reported as more than frequent complications of Covid-19 pneumonia. Of those, pneumomediastinum and pneumothorax are gaining attention. Their mechanism of occurrence/trigger is not fully understood, but the timing at which they occur is unclear.

Methods: This is a case series of 11 Covid-19 patients with pneumomediastinum; retrospectively, we shed light on some of the patients’ characteristics, the role of mechanical ventilation, and the timing of pneumomediastinum after initiation of mechanical ventilation.

Results: We found that despite following the lung-protective strategy and despite keeping a plateau pressure at an acceptable range, most of our patients had an acute event around the same timing of mechanical ventilation.

Conclusions: The similar timing raises questions about other risk factors that remain unknown. Timing and steroids can contribute to the higher incidence of these complications.

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Discussion of Clinical Cases  ISSN 2375-8449(Print)  ISSN 2375-8473(Online)

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