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Spontaneous pneumomediastinum and subcutaneous emphysema in a non-intubated COVID-19 patient: a case report


Tahir Ahmed Jatoi
Anosh Aslam Khan
Osama Mohiuddin
Muhammad Saad Choudhry
Farah Yasmin
Sumeen Jalees

Abstract

The development of spontaneous pneumomediastinum and subcutaneous emphysema are few of the rare clinical manifestations observed in coronavirus disease-19 (COVID-19) patients which are yet to be fully understood. Most cases of spontaneous pneumomediastinum arise due to factors causing high intra-alveolar pressure. Herein, we report a case of a COVID-19 positive elderly male, who presented with spontaneous pneumomediastinum and subcutaneous emphysema unrelated to high-pressure ventilatory measures, detected on chest computed tomography (CT). Despite acute medical care, the patient progressed towards a more serious clinical course. Male gender and diffuse alveolar damage caused by COVID-19 seems to be the most relevant association in this case. However, we have enlightened other possible pathological mechanisms and their association with severity index of COVID-19.


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eISSN: 1937-8688