Summary: | Background. Spontaneous pneumomediastinum is a rare complication of bronchopulmonary
diseases, due to the pandemic of a new coronavirus infection, there has been
an increase in the number of patients with this pathology, as well as with spontaneous
pneumothorax. In the latest version of the recommendations for the treatment of COVID-
19, there is no information on these complications. The purpose of the work is to study the
features of spontaneous pneumomediastinum and spontaneous pneumothorax in patients
with viral pneumonia caused by SARS-CoV-2. Materials and methods. The results of examination
and treatment of 24 patients with a complicated course of COVID-19 viral
pneumonia are presented, of which pneumomediastinum was observed in 10, spontaneous
pneumothorax – in 12, and both complications – in 2 patients. The virus was identified in
16 patients, and the rest were clinically diagnosed with COVID-19 viral pneumonia. Pneumomediastinum
and pneumothorax were confirmed by ultrasound radiological methods.
Results and conclusions. Spontaneous pneumomediastinum at the onset was detected mainly
with the help of multispiral computed tomography, did not lead to a significant deterioration
in the condition of patients and in most cases was eliminated by conservative methods.
Spontaneous pneumothorax at the onset was established using physical methods, its effect
on the course of the disease and outcomes depended on the degree of compression of the
lung and the persistence of bronchopleural communication. Pneumothorax was resolved by
drainage of the pleural cavity with intermittent vacuum aspiration. The causes of fatal outcomes
were an increase in the activity of the inflammatory process and the progression of
the volume of the affected lung tissue in elderly patients with the presence of background
and concomitant diseases. Pneumomediastinum and pneumothorax in this group of patients
occurred against the background of invasive ventilation and contributed to the development
of a fatal outcome.
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