Frequency and Risk Factors for Spontaneous Pneumomediastinum in COVID-19 Patients

Tania Guadalupe Rodriguez-Arciniega; Erick Sierra-Diaz; Jesus Armando Flores-Martinez; Maria Elena Alvizo-Perez; Irlanda Nataly Lopez-Leal; Ana Luisa Corona-Nakamura; Hermes Ernesto Castellanos-Garcia; Alejandro Bravo-Cuellar

doi:10.3389/fmed.2021.662358

Frequency and Risk Factors for Spontaneous Pneumomediastinum in COVID-19 Patients

Front Med (Lausanne). 2021 Apr 9:8:662358. doi: 10.3389/fmed.2021.662358. eCollection 2021.

Authors

Tania Guadalupe Rodriguez-Arciniega¹, Erick Sierra-Diaz^{2

3}, Jesus Armando Flores-Martinez⁴, Maria Elena Alvizo-Perez⁵, Irlanda Nataly Lopez-Leal⁶, Ana Luisa Corona-Nakamura⁷, Hermes Ernesto Castellanos-Garcia⁴, Alejandro Bravo-Cuellar⁸

Affiliations

¹ Department of Internal Medicine, Western National Medical Center (IMSS), Guadalajara, Mexico.
² Department of Public Health, University of Guadalajara, Guadalajara, Mexico.
³ Department of Urology, Western National Medical Center (IMSS), Guadalajara, Mexico.
⁴ Department of Radiology, Western National Medical Center (IMSS), Guadalajara, Mexico.
⁵ Department of Anesthesiology, Western National Medical Center (IMSS), Guadalajara, Mexico.
⁶ Department of Endocrinology, Western National Medical Center (IMSS), Guadalajara, Mexico.
⁷ Department of Infectious Diseases, Western National Medical Center (IMSS), Guadalajara, Mexico.
⁸ Department of Immunology, Western National Biomedical Center (IMSS), Guadalajara, Mexico.

Abstract

Background: Spontaneous pneumomediastinum (SPM) is an uncommon condition in COVID-19 patients. No information about outcome or risk factors is available at the time. The aim of this research is to report on the frequency and risk factors of spontaneous pneumomediastinum in COVID-19 patients. Materials and Methods: An unmatched case-control study was carried out in a tertiary health-care facility for patients with COVID-19. Electronic files were reviewed to identify patients with confirmed COVID-19 infection by RT-PCR. Univariate analysis was used to describe demographic data. Mean differences were calculated using the Mann-Whitney test. Frequency and odds ratios were calculated by standard operations. Results: A total of 271 patients were included in the study. Nine patients showed spontaneous pneumomediastinum and four of them presented associated spontaneous pneumothorax. The most common risk factors associated with poor outcomes in COVID-19 patients were not considered as risk factors for spontaneous pneumomediastinum development. Conclusion: Spontaneous pneumomediastinum is an uncommon clinical feature in COVID-19 patients. More research is necessary to formulate statements regarding prevalence, risk factors, and outcome.

Keywords: SARS-CoV-2; case-control study; complications; risk factors; spontaneous pneumomediastinum; spontaneous pneumothorax.