AI Article Synopsis
- COVID-19 can lead to mild to severe respiratory issues, particularly through hypoxemic respiratory failure often linked to lung injury and an immune response known as a cytokine storm.
- Imaging typically shows ground-glass opacities in the lungs, with an increased incidence of complications like pneumothorax and pneumomediastinum during the second wave in India (2021) compared to the first wave in 2020.
- The presence of pneumomediastinum indicates a higher risk of death and longer ICU stays, and while managing these complications remains debated, both aggressive and conservative treatment approaches have been explored.
Article Abstract
Coronavirus disease-19 (COVID-19) causes mild to moderate illness in most patients but in some cases a severe illness may manifest. Such patients usually present with hypoxaemic respiratory failure due to acute lung injury caused by a viral infection and host-mediated cytokine storm. The characteristic radiographic findings are ground-glass opacities with consolidation in posterior basal areas of bilateral lungs and rarely pneumothorax (PTX) and pneumomediastinum (PM). The incidence of these findings was notably higher in the second wave of the pandemic in India in 2021 as compared to the first wave in 2020. The etiopathogenesis of this life-threatening condition can be due to Macklin phenomenon post-cytokine-mediated diffuse alveolar injury, patient self-inflicted lung injury (P-SILI), and barotrauma in mechanically ventilated patients. The presence of pneumomediastinum is associated with higher mortality rates, prolonged intensive care unit (ICU) stays making it a poor prognostic marker. There is no consensus regarding its management in COVID-19 patients although both aggressive and conservative strategies have been tried.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489803 | PMC |
| http://dx.doi.org/10.7759/cureus.17715 | DOI Listing |
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