Spontaneous Pneumomediastinum in a SARS-CoV-2 Positive Patient Treated with High-flow Nasal Cannula: A Case Report

Main Article Content

I. Takorov Ts. Lukanova S. Simeonovski D. Vylcheva D. Dimitrov Ts. Stanimirov S. Arnaudov M. Abrasheva

Abstract

Spontaneous pneumomediastinum is one of the few rare complications of coronavirus disease – 19 (COVID-19) pneumonia. We report a case of a male patient with COVID-19 disease, severe pneumonia and spontaneous pneumomediastinum, supported via high-flow nasal cannula (HFNC) oxygen supplementation. Factors causing pneumomediastinum are discussed, but further research is still necessary.

Keywords: COVID-19, high-flow nasal cannula, spontaneous pneumomediastinum

Article Details

How to Cite
TAKOROV, I. et al. Spontaneous Pneumomediastinum in a SARS-CoV-2 Positive Patient Treated with High-flow Nasal Cannula: A Case Report. Medical Research Archives, [S.l.], v. 10, n. 1, jan. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2675>. Date accessed: 20 apr. 2024. doi: https://doi.org/10.18103/mra.v10i1.2675.
Section
Case Reports

References

1. The World Health Organization, Coronavirus disease 2019 (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. (Accessed 3 May 2020).
2. Li H, Liu S-M, Yu X-H, et al. Coronavirus disease 2019 (COVID-19): current status and future perspective. Int J Antimicrob Agents. 2020;55:3105951.
3. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
4. Xu XI, Yu C, Qu J, et al. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging. 2020;47:1-6.
5. Macia I, Moya J, Ramos R, et al. Spontaneous pneumomediastinum: 41 cases. Eur J Cardiothorac Surg. 2007;31:1110-4.
6. Kolani S, Houari N, Haloua M, et al. Spontaneous pneumomediastinum occurring in the SARS-COV-2 infection. IDCases. 2020;21:e00806.
7. Chekkoth SM, Supreeth RN, Valsala N, et al. Spontaneous pneumomediastinum in H1N1 infection: uncommon complication of a common infection. J R Coll Physicians Edinb. 2019;49(4):298-300.
8. Padhy AK, Gupta A, Aiyer P, et al. Spontaneous pneumomediastinum: a complication of swine flu. Asian Cardiovasc Thorac Ann. 2015;23(8):998-1000.
9. She WH, Chok KSH, Li IWS, et al. Pneumocystis jirovecii-related spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in a liver transplant recipient: a case report. BMC Infect Dis. 2019;19(1):66.
10. Manna S, Wruble J, Maron SZ, et al. COVID-19: a multimodality review of radiologic techniques, clinical utility and imaging features. Radiology: Cardiothoracic Imaging. 2020;2(3):e200210.
11. Becker RC, et al. COVID-19 update: Covid-19-associated coagulopathy. J Thromb Thrombolysis. 2020;50(1):54-67.
12. Channappanavar R, Perlman S, et al. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39(5):529-539.
13. Macklin MT, Macklin CC, et al. 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;23:281-358.
14. Maunder RJ, Pierson DJ, Hudson LD, et al. Subcutaneous and mediastinal emphysema: pathophysiology, diagnosis and management. Arch Intern Med. 1984;144:1447-1453.
15. Sztrymf B, Messika J, Bertrand F, et al. Beneficial effects of humidified high flow nasal oxygen in critical care patients: a prospective pilot study. Intensive Care Med. 2011;37:1780-1786.
16. Sonobe S, Inoue S, Nishiwada T, et al. A case of subcutaneous emphysema/mediastinal emphysema during the use of humidified high-flow nasal cannula. JA Clinical Reports. 2019;5:85.
17. Wali A, Rizzo V, Bille A, et al. Pneumomediastinum following intubation in COVID-19 patients: a case series. Anaesthesia. 2020;75(8):1076-1081.
18. Gorospe L, Ayala-Carbonero A, et al. Pneumomediastino espontáneo en pacientes con COVID-19: una serie de cuatro casos. Arch Bronconeumol. 2020;56:754-756.
19. Perna V, Vila E, Guelbenzu JJ, et al. Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patients. Eur J Cardiothorac Surg. 2010;37(3):573-5.
20. Chu CM, Leung YY, Hui JY, et al. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur Respir J. 2004;23(6):802-4.