A Rare Evolution to Pneumopericardium in Patient with COVID-19 Pneumonia Treated with High Flow Nasal Cannula

Abstract

Infection with severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019 (COVID-19) which was revealed an official pandemic by the World Health Organization on 11 March 2020. The current pandemic, the third of this decade, is the worst in terms of suffering and deaths related. COVID-19 represents an unprecedented challenge for medical communities and patients around the world. High-resolution computed tomography of the chest (HRCT) is a fundamental tool in both management and diagnosis of the disease. Imaging plays an essential role in the diagnosis of all the manifestations of the disease and its complications and the correct use and interpretation of imaging tests are essential. Pneumomediastinum has been reported rarely in COVID-19 patients. We were one of the first groups to share our experiences in uncommon parenchymal complications of COVID-19 with spontaneous pneumothorax and pneumomediastinum, but also with new-onset bronchiectasis and cysts. A finding of pneumopericardium is also unusual. We hereby report a rare case of spontaneous pneumopericardium in a patient with COVID-19 pneumonia treated only with a high-flow nasal cannula (HFNC).

Pneumomediastinum and Pneumopericardium as Uncommon Complications of COVID-19 Infection: A Review Article

“…Patients with asymptomatic PP can be managed conservatively, while those with tension PP should be managed with a pericardial aspiration to avoid possible hemodynamic deterioration. A drainage tube placement into the pericardial sac may be necessary if the PP is persistent or recurring [19]. Ghods et al reported a case of tension PP that required emergency echocardiography-guided catheter placement [11].…”

Editorial for the Special Issue “Emergency Medicine and Emergency Room Medical Issues”

“…The identification of several clinical conditions that represent risks of mortality for patients affected by COVID-19 [ 6 , 7 ], including the identification of several laboratory markers [ 8 , 9 ] that may play similar roles, attracted the attention of all workers in emergency departments. Furthermore, rare complications of treatments for COVID-19, such as spontaneous or ventilation-induced pneumothorax, pneumopericardium, or pneumopericardium, acquired great relevance during the outbreak [ 10 , 11 ]. Moreover, emergency departments adapted their activities to identify and manage the severe complications of vaccinations against SARS-CoV-2, such as vaccine-induced thrombocytopenia with thrombosis [ 12 ].…”