{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:36:45Z","timestamp":1787841405834,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-COV-2). Many aspects of its pathology and pathogenesis are not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>We describe a series of spontaneous air leak cases we found in our coronavirus disease 2019 (COVID-19) positive 1086-patient cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Two out of six patients eventually required mechanical ventilation and succumbed to COVID-19. We presume that acute lung injury leading to SARS-CoV-2 with associated acute respiratory distress syndrome predisposes patients to this complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This series is presented to highlight the emerging association of COVID-19 with spontaneous air leaks leading to pneumomediastinum, pneumothorax, and subsequent subcutaneous emphysema even in patients who have never received invasive mechanical ventilation and this may be more likely with the institution of high flow nasal cannula.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_939_20","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T03:16:42Z","timestamp":1617679002000},"page":"93-96","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Spontaneous pneumomediastinum and subcutaneous emphysema in patients with COVID-19"],"prefix":"10.4103","volume":"15","author":[{"given":"Reema","family":"Wadhawa","sequence":"first","affiliation":[{"name":"Department of Anesthesia, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avani","family":"Thakkar","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heena Sunil","family":"Chhanwal","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Bhalotra","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Maulana Azad Medical College, Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashpal","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Radiology, U.N. Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Wadhawa","sequence":"additional","affiliation":[{"name":"Department of Cardio Vascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"R1-20250920","article-title":"Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: Interim guidance, 13 March 2020","year":"2020","journal-title":"World Health Organization"},{"key":"R2-20250920","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1007\/s00134-020-06022-5","article-title":"Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19)","volume":"46","author":"Alhazzani","year":"2020","journal-title":"Intensive Care Med"},{"key":"R3-20250920","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1183\/09031936.04.00096404","article-title":"Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome","volume":"23","author":"Chu","year":"2004","journal-title":"Eur Respir J"},{"key":"R4-20250920","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0025-6196(11)60560-0","article-title":"Spontaneous pneumomediastinum: Analysis of 62 consecutive adult patients","volume":"84","author":"Iyer","year":"2009","journal-title":"Mayo Clin Proc"},{"key":"R5-20250920","doi-asserted-by":"crossref","first-page":"541","DOI":"10.3348\/kjr.2020.0180","article-title":"Mediastinal emphysema, giant bulla, and pneumothorax developed during the course of COVID-19 pneumonia","volume":"21","author":"Sun","year":"2020","journal-title":"Korean J Radiol"},{"key":"R6-20250920","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S2213-2600(20)30076-X","article-title":"Pathological findings of COVID-19 associated with acute respiratory distress syndrome","volume":"8","author":"Xu","year":"2020","journal-title":"Lancet Respir Med"},{"key":"R7-20250920","doi-asserted-by":"crossref","first-page":"e0487","DOI":"10.1097\/MD.0000000000010487","article-title":"Acute respiratory failure requiring mechanical ventilation in severe chronic obstructive pulmonary disease (COPD)","volume":"97","author":"Gadre","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"R8-20250920","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/S1473-3099(20)30156-0","article-title":"COVID-19 with spontaneous pneumomediastinum","volume":"20","author":"Zhou","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"R9-20250920","doi-asserted-by":"crossref","first-page":"627","DOI":"10.3348\/kjr.2020.0281","article-title":"Spontaneous pneumomediastinum: A probable unusual complication of coronavirus disease 2019 (COVID-19) pneumonia","volume":"21","author":"Wang","year":"2020","journal-title":"Korean J Radiol"},{"key":"R10-20250920","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2214\/ajr.182.1.1820049","article-title":"High-resolution CT findings in patients with severe acute respiratory syndrome: A pattern-based approach","volume":"182","author":"Chan","year":"2004","journal-title":"Am J Roentgenol"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_939_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:52:59Z","timestamp":1787838779000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_939_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_939_20","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4]]},"assertion":[{"value":"2020-09-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}