Pneumomediastinum and Pneumothorax Following Non-invasive Respiratory Support in Patients With Severe COVID-19 Disease

The coronavirus disease-2019 (COVID-19) pandemic led to an increased number of patients with pneumothorax and pneumomediastinum owing to complications attributed to viral pneumonia regardless of the use of mechanical invasive ventilation and the elapsed time of infection. The pathophysiology remains unknown. However, the Macklin effect is shown as the most plausible mechanism along with possible barotrauma secondary to a high-flow nasal cannula and noninvasive mechanical ventilation. We present two cases of patients who developed pneumomediastinum and tension pneumothorax. One of the patients was studied during infection and the other after recovery. Both received appropriate and timely treatments with successful outcomes. It is important to be aware of these potentially fatal complications as early management can reduce the associated morbidity and mortality.