Neumomediastino: una complicación frecuente de neumonía COVID-19

Introduction. Pneumomediastinum is a frequent complication in patients with COVID-19, caused in the context of a major inflammatory process Methodology. A descriptive, retrospective and cross-sectional study was conducted. We reviewed the chest CT scans and medical records of patients with/without a diagnosis of COVID-19 between April 1 and July 30, 2020. Results. We identified 66 patients with pneumomediastinum and a diagnosis of COVID-19. The prevalence found was 3.2%, 81.8% corresponded to males, the average age was 53.4 years, the average length of stay in hospital was 22.98 days, the most frequent comorbidities were obesity, diabetes and hypertension. 95.5% did not report smoking and 89.4% were not on mechanical ventilation. The most frequent symptoms were dyspnea, non-productive cough and chest pain. 69.7% of patients had a fatal outcome. Pulmonary tomography showed that 43. 9% presented moderate grade pneumomediastinum and with respect to pulmonary involvement 97% presented a typical bilateral pattern, the peak and progressive stage presented in 56.1% and 31.8% respectively and the most frequent percentage of pulmonary involvement was severe (53%). A percentage of lung involvement higher than 50% correlated directly with the severity of the pneumomediastinum (p<0.05). The average ferritin was 884.58 ug/ml, D-dimer 5.1 mg/ml, DHL 595. 55 IU/L, PCR 150.7 mg/L, lymphocytes 825.1 c/mm³, lactic acid 1.99 mmol/L, PCT 0.78 ng/ml, IL6 313 pg/ml and PaFiO2 171.5 mmHg. Conclusion. Spontaneous pneumomediastinum is a frequent complication in patients with COVID-19, being an indicator of poor evolution.