SPONTANEOUS PNEUMOMEDIASTINUM IN COVID-19 INFECTION

Abstract

Spontaneous pneumomediastinum is a condition, in which the presence of free air in the mediastinum is established, without previous trauma, surgery or other medical procedure. Due to its relative rarity and difficulty in establishing clinical manifestations, its diagnosis can easily be missed. Pneumomediastinum is rare in viral infections, with only single cases of patients with COVID-19 and pneumomediastinum reported in the literature. The clinical case presented by us is of a 58-year-old man with bilateral inflammatory lung changes associated with COVID-19 infection and development of spontaneous pneumomediastinum. The complication was controlled against the background of oxygen therapy, without the need for intubation and mechanical ventilation. Although pneumomediastinum is a rare complication in patients with COVID-19, there is evidence that its occurrence is a factor associated with disease exacerbation as well as an increased risk of death. Early diagnosis of pneumomediastinum enables better management of the acute respiratory failure with conservative approach, which improves the prognosis in these patients.