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COVID-19 Pneumonia Associated with Pneumomediastinum and Pneumothorax: Epidemiology and Evolution

Rim Khemakhem1, Issraa Wadhane1, Wided Dhouib2

  • 1Department of Pneumology, HEDI CHAKER Hospital, University of Sfax, Sfax, Tunisia.

Tanaffos
|July 24, 2025
PubMed
Abstract

Insights

Pneumomediastinum and pneumothorax are rare COVID-19 complications. These conditions, especially when spontaneous, are linked to increased mortality, highlighting the need for further research into risk factors and management strategies.

Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Pneumomediastinum (PM) and pneumothorax (PTX) are uncommon complications observed in patients with COVID-19 pneumonia.
  • The precise pathophysiological mechanisms underlying PM and PTX in COVID-19 remain incompletely understood.

Purpose of the Study:

  • To investigate the occurrence, management, and outcomes of pneumomediastinum and pneumothorax in hospitalized COVID-19 patients.
  • To identify potential risk factors and associations with mortality in COVID-19 patients experiencing PM or PTX.

Main Methods:

  • A retrospective study conducted from March to July 2021.
  • Inclusion criteria: hospitalized patients diagnosed with COVID-19 who developed PM or PTX.
  • Data analysis focused on prevalence, management strategies, and correlation with mortality and clinical parameters.

Main Results:

  • Thirty-three COVID-19 patients with PM or PTX were analyzed.
  • PM prevalence was 1.2% (spontaneous) and 1.71% (iatrogenic).
  • Mortality was significantly associated with PM occurrence, patient age, radiological severity, respiratory infection severity, compression signs, and mechanical ventilation use.

Conclusions:

  • COVID-19 patients experiencing PM-PTX exhibit a potentially higher mortality rate.
  • Further research is essential to elucidate risk factors and establish standardized management protocols for PM-PTX in COVID-19.
Keywords:
CoronavirusPneumothoraxPrognosisSevere acute respiratory syndromeTreatment

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