1. Pneumomediastinum in COVID-19: a phenotype of severe COVID-19 pneumonitis? The results of the United Kingdom (POETIC) survey
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James Melhorn, Andrew Achaiah, Francesca M. Conway, Elizabeth M.F. Thompson, Erik W. Skyllberg, Joseph Durrant, Neda A. Hasan, Yasser Madani, Prasheena Naran, Bavithra Vijayakumar, Matthew J. Tate, Gareth E. Trevelyan, Irfan Zaki, Catherine A. Doig, Geraldine Lynch, Gill Warwick, Avinash Aujayeb, Karl A. Jackson, Hina Iftikhar, Jonathan H. Noble, Anthony Y.K.C. Ng, Mark Nugent, Philip J. Evans, Robert A. Hastings, Harry R. Bellenberg, Hannah Lawrence, Rachel L. Saville, Nikolas T. Johl, Adam N. Grey, Huw C. Ellis, Cheng Chen, Thomas L. Jones, Nadeem Maddekar, Shahul Leyakathali Khan, Ambreen Iqbal Muhammad, Hakim Ghani, Yadee Maung Maung Myint, Cecillia Rafique, Benjamin J. Pippard, Benjamin R.H. Irving, Fawad Ali, Viola H. Asimba, Aqeem Azam, Eleanor C. Barton, Malvika Bhatnagar, Matthew P. Blackburn, Kate J. Millington, Nicholas J. Budhram, Katherine L. Bunclark, Toshit P. Sapkal, Giles Dixon, Andrew J.E. Harries, Mohammad Ijaz, Vijayalakshmi Karunanithi, Samir Naik, Malik Aamaz Khan, Karishma Savlani, Vimal Kumar, Beatriz Lara Gallego, Noor A. Mahdi, Caitlin Morgan, Neena Patel, Elen W. Rowlands, Matthew S. Steward, Richard S. Thorley, Rebecca L. Wollerton, Sana Ullah, David M. Smith, Wojciech Lason, Anthony J. Rostron, Najib M. Rahman, Rob J. Hallifax, Durrant, Joseph [0000-0003-0548-9952], Aujayeb, Avinash [0000-0002-0859-5550], Jackson, Karl A [0000-0002-6464-7474], Hastings, Robert A [0000-0001-5338-4851], Ellis, Huw C [0000-0002-4351-1658], Jones, Thomas L [0000-0002-6324-7540], Irving, Benjamin RH [0000-0003-3610-6467], Azam, Aqeem [0000-0001-9270-1127], Gallego, Beatriz Lara [0000-0003-0090-8206], Steward, Matthew S [0000-0002-1873-4665], Lason, Wojciech [0000-0002-1036-6108], Rostron, Anthony J [0000-0002-9336-1723], and Apollo - University of Cambridge Repository
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Pulmonary and Respiratory Medicine ,Infectious Diseases ,Clinical Research ,32 Biomedical and Clinical Sciences ,3 Good Health and Well Being ,FOS: Health sciences ,3202 Clinical Sciences ,Lung - Abstract
BackgroundThere is an emerging understanding that coronavirus disease 2019 (COVID-19) is associated with increased incidence of pneumomediastinum (PTM). We aimed to determine its incidence among patients hospitalised with COVID-19 in the UK and describe factors associated with outcome.MethodsA structured survey of PTM and its incidence was conducted from September 2020 to February 2021. UK-wide participation was solicitedviarespiratory research networks. Identified patients had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and radiologically proven PTM. The primary outcomes were to determine incidence of PTM in COVID-19 and to investigate risk factors associated with patient mortality.Results377 cases of PTM in COVID-19 were identified from 58 484 inpatients with COVID-19 at 53 hospitals during the study period, giving an incidence of 0.64%. Overall 120-day mortality in COVID-19 PTM was 195 out of 377 (51.7%). PTM in COVID-19 was associated with high rates of mechanical ventilation. 172 out of 377 patients (45.6%) were mechanically ventilated at the point of diagnosis. Mechanical ventilation was the most important predictor of mortality in COVID-19 PTM at the time of diagnosis and thereafter (pConclusionsPTM appears to be a marker of severe COVID-19 pneumonitis. The majority of patients in whom PTM was identified had not been mechanically ventilated at the point of diagnosis.
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- 2021