TY - JOUR
T1 - Pneumomediastinum in patients with COVID-19 undergoing CT pulmonary angiography
T2 - a retrospective cohort study
AU - Baslas, Rohit
AU - Condurache, Dorina Gabriela
AU - Jayal, Ambikesh
AU - Colquhoun, Matthew
AU - De Wolff, Jacob Frederik
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: Various complications have been reported in patients with COVID-19 including pneumomediastinum. Methods: The primary objective of the study was to determine the incidence of pneumomediastinum in COVID-19 positive patients who underwent CT pulmonary angiography (CTPA). The secondary objectives were to analyse if the incidence of pneumomediastinum changed between March and May 2020 (peak of the first wave in the UK) and January 2021 (peak of the second wave in the UK) and to determine the mortality rate in patients with pneumomediastinum. We undertook an observational, retrospective, single-centre, cohort study of patients with COVID-19 admitted to Northwick Park Hospital. Results: 74 patients in the first wave and 220 patients in the second wave met the study criteria. Two patients during the first wave and eleven patients during the second wave developed pneumomediastinum. Conclusions: The incidence of pneumomediastinum changed from 2.7% during the first wave to 5% during the second wave and this change was not statistically significant (p value 0.4057). The difference in mortality rates of patients with pneumomediastinum in both waves of COVID-19 (69.23%) versus patients without pneumomediastinum in both waves of COVID-19 (25.62%) was statistically significant (p value 0.0005). Many patients with pneumomediastinum were ventilated, which could be a confounding factor. When controlling for ventilation, there was no statistically significant difference in the mortality rates of ventilated patients with pneumomediastinum (81.81%) versus ventilated patients without pneumomediastinum (59.30%) (p value 0.14).
AB - Background: Various complications have been reported in patients with COVID-19 including pneumomediastinum. Methods: The primary objective of the study was to determine the incidence of pneumomediastinum in COVID-19 positive patients who underwent CT pulmonary angiography (CTPA). The secondary objectives were to analyse if the incidence of pneumomediastinum changed between March and May 2020 (peak of the first wave in the UK) and January 2021 (peak of the second wave in the UK) and to determine the mortality rate in patients with pneumomediastinum. We undertook an observational, retrospective, single-centre, cohort study of patients with COVID-19 admitted to Northwick Park Hospital. Results: 74 patients in the first wave and 220 patients in the second wave met the study criteria. Two patients during the first wave and eleven patients during the second wave developed pneumomediastinum. Conclusions: The incidence of pneumomediastinum changed from 2.7% during the first wave to 5% during the second wave and this change was not statistically significant (p value 0.4057). The difference in mortality rates of patients with pneumomediastinum in both waves of COVID-19 (69.23%) versus patients without pneumomediastinum in both waves of COVID-19 (25.62%) was statistically significant (p value 0.0005). Many patients with pneumomediastinum were ventilated, which could be a confounding factor. When controlling for ventilation, there was no statistically significant difference in the mortality rates of ventilated patients with pneumomediastinum (81.81%) versus ventilated patients without pneumomediastinum (59.30%) (p value 0.14).
KW - adult intensive & critical care
KW - COVID-19
KW - general medicine
UR - http://www.scopus.com/inward/record.url?scp=85128915317&partnerID=8YFLogxK
U2 - 10.1136/postgradmedj-2022-141642
DO - 10.1136/postgradmedj-2022-141642
M3 - Review article
C2 - 35428734
AN - SCOPUS:85128915317
SN - 0032-5473
VL - 99
SP - 570
EP - 575
JO - Postgraduate Medical Journal
JF - Postgraduate Medical Journal
IS - 1172
ER -