Home > Journals > Minerva Medica > Past Issues > Minerva Medica 2021 December;112(6) > Minerva Medica 2021 December;112(6):779-85

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

ORIGINAL ARTICLE   

Minerva Medica 2021 December;112(6):779-85

DOI: 10.23736/S0026-4806.21.07585-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Pneumomediastinum associated with severe pneumonia related to COVID-19: diagnosis and management

Corinna GANDOLFO 1, Monica BONFIGLIO 1, Giulia SPINETTO 1, Gianluca FERRAIOLI 2, Cornelius BARLASCINI 3, Antonello NICOLINI 4 , Paolo SOLIDORO 5, 6

1 COVID-19 Intensive Care Unit, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy; 2 COVID-19 Unit, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy; 3 Unit of Hygiene and Health Medicine, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy; 4 Unit of Respiratory Diseases, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy; 5 Department of Medical Sciences, University of Turin, Turin, Italy; 6 Division of Respiratory Diseases, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, Turin, Italy



BACKGROUND: Pneumomediastinum (PNM) can develop as a severe complication of severe COVID-19 and may be correlated with greater morbidity and mortality. PNM is a rarely reported complication in COVID-19 patients and usually associated with endotracheal intubation.
METHODS: Our aim was to describe the characteristics of patients with PNM in twenty-one patients with COVID-19 related pneumonia and acute respiratory failure in a retrospective case series.
RESULTS: Twenty-one patients were diagnosed, four were treated with high-flow nasal cannula, thirteen with non invasive ventilation and four with invasive mechanical ventilation. In five cases PNM was massive and associated to subcutaneous emphysema; more rarely PNM was associated with pneumothorax. Conservative management was the most used therapeutic strategy.
CONCLUSIONS: PNM is a serious and not extremely rare complication of severe forms of pulmonary involvement of COVID-19. The clinician should consider this rare complication; moreover, we suggest being careful when clinicians start mechanical ventilation.


KEY WORDS: COVID-19; Pneumonia; Pneumomediastinum, diagnostic

top of page