TY - JOUR T1 - Interstitial lung disease-related pneumomediastinum in COVID-19 patients JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00014-2021 VL - 7 IS - 1 SP - 00014-2021 AU - Kim Blanc AU - Nicolas Bonnet AU - Elise Ouedraogo AU - Michel Arnaout AU - Maxime Patout AU - Yacine Tandjaoui-Lambiotte Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/7/1/00014-2021.abstract N2 - We read with interest the work of Lemmers et al. [1] published recently in this journal. We also found that spontaneous pneumomediastinum is an uncommon presentation of severe coronavirus disease 2019 (COVID-19) patients. The mechanisms of pneumomediastinum remain unclear [2]. From March 2020 to November 2020 we identified eight patients with pneumomediastinum at intensive care unit admission among 401 COVID-19 patients in two Seine-Saint-Denis hospitals in the Paris (France) area. Neither risk factor nor underlying respiratory disease was identified in these patients. Spontaneous pneumomediastinum occurred without mechanical ventilation (neither noninvasive nor invasive) for four patients and on the day following tracheal intubation despite lung-protective invasive ventilation for the others. Tracheal and bronchial integrity was verified by direct bronchoscopic examination and high-resolution chest computed tomography. As reported by Lemmers et al. [1], plateau pressure was constantly <25 cmH2O in the four patients under invasive mechanical ventilation, suggesting that pneumomediastinum were not related to barotrauma or traumatic tracheal intubation.Pneumomediastinum in severe #COVID19 presentations could be due to a lung parenchymal retractive process generated by intense inflammation as in acute exacerbation of idiopathic pulmonary fibrosis or MDA-5 acute interstitial lung disease https://bit.ly/3qzBYMW ER -