Clinical, Laboratory and Radiological Evaluation of Intensive Care Patients Who Developed COVID-19 Associated Pneumomediastinum

Objective: This study aims to identify possible risk factors and clinical, laboratory, or radiological predictors for COVID-19 associated pneumomediastinum. Methods: Patients who developed pneumomediastinum under mechanical ventilation (MV) due to COVID-19 pneumonia during intensive care unit (ICU) (Group 1), and patients who died without developing pneumomediastinum during ICU (Group 2) were compared statistically in terms of age, laboratory parameters, medical treatments, mechanical ventilator parameters, and radiological findings. Results: Group 1 patients were significantly younger than Group 2 patients (p<0.05). There was no significant difference between groups in terms of laboratory parameters except N/ L ratios and sedimentation rates (p>0.05). There was no significant difference between the groups in terms of dominant infiltration pattern, pleural and pericardial effusion (p>0.05). The incidence of organizing pneumonia pattern, and infiltration of more than 75% of the total lung parenchyma were significantly higher in Group 1 (p<0.01). The rates of favipiravir treatment, immunomodulatory therapy and prone positioning were significantly lower in Group 1 than Group 2 (p<0.01). There was no significant difference between groups in terms of the duration of ICU hospitalization and MV, PEEPmax, PIPmax and PaO2/FiO(2) ( p> 0.05). Conclusion: Care should be taken in terms of pneumomediastinum in patients who show diffuse organized pneumonia patterns affecting more than 75% of the parenchyma area.