Isolated pneumomediastinum in severe category COVID-19 patients admitted in ICU: a case series

BACKGROUND: Pneumomediastinum is a rare complication associated with acute respiratory distress syndrome secondary to other viral pneumonias. However, it has been on a rise in COVID-19 patients with severe disease. CASE PRESENTATION: We present three cases to highlight that isolated pneumomediastinum can complicate the course of illness in patients on non-invasive ventilation. In our case series, two COVID-19 diagnosed cases with no previous history of intubation developed pneumomediastinum. They were managed conservatively with a successful outcome. The third patient developed PM with subcutaneous emphysema post-intubation, although managed conservatively succumbed to the disease. CONCLUSIONS: Clinicians need to be alert to the development of such a complication in the event of sudden onset dyspnoea with chest pain. Conservative management, with low pressure settings on the ventilator results in gradual improvement of patient.