Rare Complications of COVID-19 Pneumonia: Pneumomediastinum and Atrial Fibrillation

Abstract

Objective: Coronavirus disease 2019(COVID-19) is considered as systemic disease involving many vital organs in addition to the lungs, including the heart, liver, and kidneys. Pneumomediastinum associated with COVID-19 pneumonia is a rare condition usually seen in patients with underlying lung pathology, infections, or mechanical intubation. We presented a case of late diagnosis of pneumomediastinum and atrial fibrillation in COVID-19 patient undergoing Noninvasive mechanical ventilation (NIMV). Case: A 66-year-old male patient with a history of COVID-19 pneumonia and 19 days hospital follow up and a NIMV treatment was admitted to our emergency department with palpitations and dyspnea. Thoracic CT and electrocardiography revealed, scattered ground glass areas, pneumomediastinum and high-velocity atrial fibrillation, respectively. Conclusion: We recommend regular checks with imaging methods and ECG during follow-up in patients with COVID-19. Clinicians should remember that ventilator-related lung damage may be seen in COVID-19 patients undergoing NIMV.

Keywords

• COVID-19
• pneumomediastinum
• positive pressure ventilation
• atrial fibrillation

COVID-19 Pnömonisinin Nadir Komplikasyonları: Pnömomediastinum ve Atriyal Fibrilasyon

Abstract

Giriş: Koronavirüs hastalığı 2019 (COVID–19), akciğerlere ek olarak kalp, karaciğer ve böbrekler dahil olmak üzere birçok hayati organı içeren sistemik bir hastalık olarak kabul edilir. COVID–19 pnömonisi ile ilişkili pnömomediastinum, genellikle altta yatan akciğer patolojisi, enfeksiyonları veya mekanik entübasyonu olan hastalarda görülen nadir bir durumdur. Burada, noninvazif mekanik ventilasyon (NIMV) uygulanan COVID–19 hastasında geç tanı konulan bir pnömomediastinum ve atriyal fibrilasyon olgusunu sunduk. Olgu: COVID–19 pnömonisi için 19 gün hastane takibi ve NIMV tedavisi öyküsü olan 66 yaşında erkek hasta, acil servisimize çarpıntı ve nefes darlığı şikayeti ile başvurdu. Torasik BT ve elektrokardiyografide sırasıyla dağınık buzlu cam alanları, pnömomediastinum ve yüksek hızlı atriyal fibrilasyon saptandı. Sonuç: COVID–19 hastalarında takip sırasında görüntüleme yöntemleri ve elektrokardiyografi ile düzenli kontroller yapılmasını öneriyoruz. Klinisyenler, NIMV uygulanan COVID–19 hastalarında vantilatöre bağlı akciğer hasarının görülebileceğini akılda tutmalıdır.

Keywords

• COVID-19
• Pnömomediastinum
• Pozitif basınçlı ventilasyon
• Atrial fibrilasyon

References

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