Is Spontaneous Pneumomediastinum a Poor Prognostic Factor in Covid-19?

Ozsoy, Ibrahim Ethem; Tezcan, Mehmet Akif; Guzeldag, Seda; Ozdemir, Ayse Turunc

OBJECTIVE To determine the risk factors for spontaneous pneumomediastinum (SPM), its clinical course and effect on prognosis in patients with Coronavirus disease-19 (COVID-19) pneumonia. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Kayseri City Training and Research Hospital, Turkey, from April to September 2020. METHODOLOGY All COVID-19 patients' clinical, laboratory, and radiologic characteristics, as well as treatment outcome data, were obtained through medical record extraction. Group A had 50 patients (22 men and 28 women) without SPM, and Group B had 20 patients (10 men and 10 women) with SPM. RESULTS Considering the accompanying comorbidities, the frequencies of asthma and inhaler-use was significantly higher in Group B than in Group A (p <0.05). In the CT evaluation at presentation, the rate of involvement of all five lobes of the lung in Group B was significantly higher than in Group A. Rates of tube thoracostomy, mechanical ventilator requirement, length of stay in hospital, and exitus were significantly higher in Group B than in Group A (p <0.05). CONCLUSION SPM development in a patient with COVID-19 pneumonia is a sign that the prognosis will not be good, and these patients need a more aggressive treatment. Key Words: Spontaneous pneumomediastinum, COVÄ°D-19, Pneumothorax, Real-time polymerase chain reaction, Subcutaneous emphysema.