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Spontaneous Pneumomediastinum and Pneumopericardium in a Young Adult with COVID-19: A Case Report

Extrapulmonary air extravasation has been reported as a complication of
the coronavirus disease 2019 (COVID-19), although largely in patients on
mechanical ventilation who experience pulmonary barotrauma. Simultaneous
pneumomediastinum and pneumopericardium have seldom been reported,
especially in patients without predisposing risk factors. We present the case of
a previously healthy, 21-year-old male hospitalized for a COVID-19 infection who
was found to have spontaneous pneumomediastinum and pneumopericardium
on imaging. He required oxygen via face mask and had elevated inflammatory
markers with significant pulmonary involvement but made a successful recovery.
Pneumomediastinum and pneumopericardium have the potential to cause
adverse outcomes such as cardiac tamponade and their impact in COVID-19 is not
yet known, although preliminary research indicates it may predispose to worse
outcomes. Awareness of this novel disease process could help elucidate its true
prognostic value and inform a need for intervention. Overall, this case report adds
to the growing body of evidence regarding COVID-19 and its extrapulmonary


Tess N. Engel*, Nilang N. Shah and Michael Kwong

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