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

Abstract

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.