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纵隔气肿:COVID-19罕见并发症的影像学特征及相关因素

Pneumomediastinum: Radiological profile and associations of uncommon complication of COVID-19.

作者信息

Sarda Prashant, Thakker Vishal, Waikhom Premila D, Arora Manali, Sharma Rohit, Baisoya Sovinder, Rawat Jagdish, Azad Rajiv K

机构信息

Department of Radiodiagnosis, SGRRIM and HS, Dehradun, Uttarakhand, India.

Department of Pediatrics, SGRRIM and HS, Dehradun, Uttarakhand, India.

出版信息

J Family Med Prim Care. 2022 Feb;11(2):537-541. doi: 10.4103/jfmpc.jfmpc_1346_21. Epub 2022 Feb 16.

Abstract

INTRODUCTION

Spontaneous pneumomediastinum is an uncommon complication of Corona Virus Disease (COVID)-19 presenting mostly in moderate to severe cases.

MATERIALS AND METHODS

This is a retrospective observational imaging and hospital data-based study done on 15 confirmed patients of COVID-19 who underwent high resolution computed tomography (HRCT) thorax at the Department of Radio-Diagnosis of a tertiary medical center in the Himalayan foothills. The clinico-radiological profile of the study group was assessed and it was aimed at finding the association of pneumomediastinum with the severity of lung changes.

RESULTS

A strong association of pneumomediastinum was observed with severe lung changes on HRCT thorax ( = 13, 87%, < 0.00001). Dyspnea was the most common presenting factor. The mortality rate is high in mechanically intubated patients of pneumomediastinum with COVID-19 (75%).

CONCLUSION

Pneumomediastinum is a complication of a severe COVID-19 disease spectrum. Along with severe lung parenchymal disease, systemic inflammation, systemic steroid therapy, comorbid state, and mechanical intubation, it is a part of the pool of poor prognostic factors. HRCT is essential for making a quick and comprehensive diagnosis, thereby, guiding the clinician for further management.

摘要

引言

自发性纵隔气肿是冠状病毒病(COVID)-19的一种罕见并发症,主要出现在中重度病例中。

材料与方法

这是一项基于回顾性观察影像学和医院数据的研究,对15例确诊的COVID-19患者进行了研究,这些患者在喜马拉雅山麓一家三级医疗中心的放射诊断科接受了胸部高分辨率计算机断层扫描(HRCT)。评估了研究组的临床放射学特征,旨在发现纵隔气肿与肺部病变严重程度之间的关联。

结果

观察到纵隔气肿与胸部HRCT上的严重肺部病变密切相关( = 13,87%,< 0.00001)。呼吸困难是最常见的表现因素。COVID-19合并纵隔气肿的机械通气患者死亡率很高(75%)。

结论

纵隔气肿是严重COVID-19疾病谱的一种并发症。除了严重的肺实质疾病、全身炎症、全身类固醇治疗、合并症状态和机械通气外,它也是不良预后因素之一。HRCT对于快速全面诊断至关重要,从而指导临床医生进行进一步治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01ff/8963614/538129191533/JFMPC-11-537-g001.jpg

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