Spontaneous pneumothorax and pneumomediastinum in sars-cov-2 pneumonia: Case series

Abstract

Introduction: Pneumothorax and pneumomediastinum associated with COVID-19 are rare complications, with an estimated incidence of 0.56 to 2% of cases. They can occur in different phases of the disease and in absence of risk factors. Objective: To describe two pneumothorax cases and other with pneumomediastinum associated with COVID-19 pneumonia. Material and methods: Retrospective case series. Results: Within the demographic characteristics, the age between 50 to 70 years old stands out, no respiratory comorbidities or smoking. The mean time between the onset of symptoms and the event was 14.6 days. There was a single case with concomitant bilateral pneumothorax with pneumomediastinum. Treatment consisted of conservative management for the pneumomediastinum. Both pneumothorax cases performed closed thoracostomy, one of them required pleurectomy with decortication due to non-re-expansion of the compromised lung. The mean hospital stay was 31.3 days. All patients had a satisfactory clinical evolution. Conclusions: Pneumothorax and pneumomediastinum are potentially fatal complications of COVID-19. It can occur in the absence of respiratory disease, previous smoking or mechanical ventilation. It should be suspected in all patients who present respiratory deterioration in the course of the disease. © 2021, Instituto Nacional de Enfermedades Respiratorias. All rights reserved.