Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in non-ventilated COVID-19 patients

Shadi Hamouri; Mohammad AlQudah; Omar Albawaih; Nabil Al-Zoubi; Sebawe Syaj

doi:10.2144/fsoa-2021-0090

Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in non-ventilated COVID-19 patients

Future Sci OA. 2021 Nov 18;8(2):FSO771. doi: 10.2144/fsoa-2021-0090. eCollection 2022 Feb.

Authors

Shadi Hamouri¹, Mohammad AlQudah², Omar Albawaih¹, Nabil Al-Zoubi¹, Sebawe Syaj¹

Affiliations

¹ Department of General Surgery & Urology, Faculty of Medicine, Jordan University of Science & Technology, King Abdullah University Hospital, Irbid, 22110, Jordan.
² Department of Pathology & Microbiology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan.

Abstract

Aim: Pneumothorax (PNX), pneumomediastinum (PMD) and subcutaneous emphysema (SCE) are COVID-19 complications related to positive-pressure ventilation. We analyzed the pathophysiology of these complications without ventilation.

Patients & methods: Out of 1845 admitted COVID-19 patients, we retrospectively collected data for 15 patients, from a tertiary medical center, from 1 October 2020 to 31 March 2021.

Results: Five patients suffered from spontaneous PNX, 8/15 developed PMD and 8/15 developed SCE. The mean BMI was 29.7, as most patients were obese or overweight. Most patients had lymphocytopenia and increased C-reactive protein, ferritin and lactate dehydrogenase levels. Eleven patients succumbed to the disease.

Conclusion: Risk factors of spontaneous PNX, PMD and SCE in COVID-19 patients need further investigations by conducting more comprehensive case-control studies.

Keywords: COVID-19; pneumomediastinum; spontaneous pneumothorax; subcutaneous emphysema.