Aim: Pneumothorax (PNX), pneumomediastinum (PMD) and subcutaneous emphysema (SCE) are COVID-19 complications related to positive-pressure ventilation. We analyzed the pathophysiology of these complications without ventilation. Patients & methods: Out of 1845 admitted COVID-19 patients, we retrospectively collected data for 15 patients, from a tertiary medical center, from 1 October 2020 to 31 March 2021. Results: Five patients suffered from spontaneous PNX, 8/15 developed PMD and 8/15 developed SCE. The mean BMI was 29.7, as most patients were obese or overweight. Most patients had lymphocytopenia and increased C-reactive protein, ferritin and lactate dehydrogenase levels. Eleven patients succumbed to the disease. Conclusion: Risk factors of spontaneous PNX, PMD and SCE in COVID-19 patients need further investigations by conducting more comprehensive case–control studies. Lay abstract We have investigated spontaneous alveolar rupture as a complication in 15 COVID-19 patients. Manifested as pneumothorax, pneumomediastinum and subcutaneous emphysema, these complications are less common in patients without mechanical ventilation. Management of these patients was either conservative or by insertion of a chest tube. Eventually, 11 out of 15 patients have passed away due to respiratory failure. Graphical abstract
【저자키워드】 COVID-19, Pneumomediastinum, subcutaneous emphysema, Spontaneous pneumothorax, 【초록키워드】 Respiratory failure, mechanical ventilation, Ventilation, C-reactive protein, ferritin, lactate dehydrogenase, pathophysiology, Chest, lymphocytopenia, Patient, Complication, Pneumothorax, patients, COVID-19 patients, COVID-19 patient, Factor, Abstract, collected data, obese, insertion, emphysema, rupture, alveolar, analyzed, investigated, the disease, Most patient, less, suffered, 【제목키워드】 COVID-19 patient, emphysema,