Unusual presentations of COVID-19 pneumonia on CT scans with spontaneous pneumomediastinum and loculated pneumothorax: A report of two cases and a review of the literature.
Barbara Brogna, Elio Bignardi, Petronilla Salvatore and 6 others
PMID 32693960WHAT IT FOUND
Chest CT in two COVID-19 pneumonia patients showed rare pneumomediastinum and loculated pneumothorax; follow-up CT showed less air in one and improvement in the other.
These are case reports, not proof any treatment worked.
Key findings
01A 78-year-old woman with positive sputum RT-PCR for SARS-CoV-2 had chest CT showing pneumomediastinum.
02A 41-year-old man with positive sputum RT-PCR for SARS-CoV-2 had chest CT showing loculated pneumothorax, pneumomediastinum, and subcutaneous emphysema.
03Follow-up CT showed pneumomediastinum reduction in the first patient and improvement in the second.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only two patients are described, so this cannot show how common these CT findings are or whether they change outcomes. There was no comparison group, so it cannot show whether the drugs, oxygen, non-invasive support, or chest drain improved the patients. Each patient received several treatments at the same time, so the contribution of any single component cannot be separated. The literature review is not described as a systematic search. Follow-up was short, only one week for the first patient and five days for the second.
Declared interests
The authors state they had no conflicts of interest and the research received no specific grant from public, commercial, or not-for-profit funding agencies.
The easy way to misread this
Do not read the follow-up CT improvements as proof that the drugs, oxygen, non-invasive support, or chest drain worked. These were two patients, there was no comparison group, and each received several treatments at once, so no single treatment can be credited.