Spontaneous Pneumomediastinum in Covid-19 Pneumonia: Two Cases and Review of the Literature

Spontaneous pneumomediastinum (PM) is a rare presentation associated with Coronavirus disease 2019 (COVID-19). Here, we report two cases presented with spontaneous PM associated with COVID-19 pneumonia.A 58-year-old female patient was admitted to the Emergency Department (ED) with dyspnea, hoarseness, myalgia, and cough. A chest CT scan revealed subcutaneous emphysema, diffuse PM, bilateral diffuse areas of ground-glass opacity, and consolidations. The patient was transferred to the critical care unit. In critical intensive care, the patient developed multi-organ failure and expired on the 10th day. A 34-year-old male patient admitted to the ED with dyspnea and cough. A chest CT scan revealed diffuse PM, bilateral diffuse areas of ground-glass opacity, and consolidations. The patient was transferred to the critical care unit. His progress was uneventful and he was discharged after 12 days. Patients suspected of PM should be examined closely during the differential diagnosis of chest pain, dyspnea, subcutaneous emphysema, and various lung- and heart-induced states. Patients diagnosed with spontaneous PM should be hospitalized for observation because the condition can be associated with complications, including death.