Pneumomediastinum as a predictor of adverse outcome in patients with coronavirus pneumonia

Abstract

Aim. Analysis of the course of coronavirus pneumonia in patients with pneumomediastinum. Methods. The study included 139 patients, 71 of whom developed spontaneous pneumomediastinum associated with coronavirus pneumonia. Laboratory, clinical and radiological data were analyzed and compared. Results. An association between severity of viral pneumonia (multispiral computed tomography severity score 3-4) and pneumomediastinum was found. Spontaneous mediastinal emphysema in patients with COVID-19 significantly more often resulted in the development of acute respiratory distress syndrome and multiple organ failure and can be a predictor of adverse outcome. Conclusion. Pneumomediastinum in patients with viral pneumonia caused by new coronavirus infection COVID-19 is a factor of extremely unfavorable prognosis and a predictor of severe course of the disease. In progressive spontaneous mediastinal emphysema without pneumothorax, Razumovsky mediastinotomy is recommended, and in case of clinically significant concomitant pneumothorax, drainage and revision of the mediastinum should be considered.