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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medvis</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинская визуализация</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Visualization</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1607-0763</issn><issn pub-type="epub">2408-9516</issn><publisher><publisher-name>RDS-Media Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24835/10.24835/1607-0763-1086</article-id><article-id custom-type="elpub" pub-id-type="custom">medvis-1086</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>COVID-19</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>COVID-19</subject></subj-group></article-categories><title-group><article-title>Спонтанный пневмомедиастинум, пневмоторакс, пневмоперитонеум и эмфизема мягких тканей как осложнения у пациентов с COVID-19, серия клинических наблюдений</article-title><trans-title-group xml:lang="en"><trans-title>Spontaneous pneumomediastinum, pneumothorax, pneumoperitoneum and soft tissue emphysema as complication in patients with COVID-19, series of cases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0381-0397</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Назарова</surname><given-names>Г. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Nazarova</surname><given-names>G. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Назарова Галина Борисовна – аспирант кафедры лучевой диагностики; врач-рентгенолог отделения лучевой диагностики КДО АНО ЦКБ имени Св. Алексия</p><p>117574 Москва, ул. Вильнюсская, д. 17, кв. 157</p><p>Тел.: +7-906-032-94-35</p><p>119192 Москва, Ломоносовский проспект, 27, к. 10</p></bio><bio xml:lang="en"><p>Galina B. Nazarova – PhD Student at Radiology department; Radiologist at Radiology department with CT and MRI; Radiologist at Radiology department, St. Alexy Central Clinical Hospital</p><p>17, Vilnyusskaya str., 117574 Moscow</p><p> Phone: +7-906-032-94-35 </p><p>27-10, Lomonosovsky prospekt, 119192 Moscow</p></bio><email xlink:type="simple">gbkalchenko@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1266-4926</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мершина</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mershina</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мершина Елена Александровна – канд. мед. наук, доцент кафедры лучевой диагностики и лучевой терапии, заведующая отделением рентгенодиагностики с кабинетами МРТ и КТ </p><p>119192 Москва, Ломоносовский проспект, 27, к. 10</p></bio><bio xml:lang="en"><p>Elena A. Mershina – Cand. of Sci. (Med.), Assistant Professor of Radiology department, Head of Radiology department</p><p>27-10, Lomonosovsky prospekt, 119192 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8402-7643</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лисицкая</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lisitskaya</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лисицкая Мария Валерьевна – канд. мед. наук, врач-рентгенолог</p><p>119192 Москва, Ломоносовский проспект, 27, к. 10</p></bio><bio xml:lang="en"><p>Maria V. Lisitskaya – Cand. of Sci. (Med.), Radiologist at Radiology department</p><p>27-10, Lomonosovsky prospekt, 119192 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7533-9867</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Плотникова</surname><given-names>М. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Plotnikova</surname><given-names>M. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Плотникова Мария Леонидовна – врач-рентгенолог</p><p>119192 Москва, Ломоносовский проспект, 27, к. 10</p></bio><bio xml:lang="en"><p>Maria L. Plotnikova – Radiologist at Radiology department</p><p>27-10, Lomonosovsky prospekt, 119192 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7757-6273</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баженова</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bazhenova</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баженова Дарья Анатольевна – аспирант кафедры лучевой диагностики и лучевой терапии, врач-рентгенолог отделения рентгенодиагностики с кабинетами МРТ и КТ</p><p>119192 Москва, Ломоносовский проспект, 27, к. 10</p></bio><bio xml:lang="en"><p>Daria A. Bazhenova – PhD Student at Radiology department; Radiologist at Radiology department with CT and MRI</p><p>27-10, Lomonosovsky prospekt, 119192 Moscow</p></bio><email xlink:type="simple">bazhenova.darya@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Малахов</surname><given-names>П. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Malakhov</surname><given-names>P. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Малахов Павел Сергеевич – заведующий отделением реанимации</p><p>119192 Москва, Ломоносовский проспект, 27, к. 10</p></bio><bio xml:lang="en"><p>Pavel S. Malakhov – Head of the Intensive Care department</p><p>27-10, Lomonosovsky prospekt, 119192 Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Медицинский научно-образовательный центр ФГБОУ ВО “Московский государственный университет имени М.В. Ломоносова”; Факультет фундаментальной медицины ФГБОУ ВО “Московский государственный университет имени М.В. Ломоносова”</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Medical Research and Education Center of Lomonosov Moscow State University; Faculty of Fundamental Medicine Lomonosov Moscow State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Медицинский научно-образовательный центр ФГБОУ ВО “Московский государственный университет имени М.В. Ломоносова”</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Medical Research and Education Center of Lomonosov Moscow State University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>05</day><month>03</month><year>2022</year></pub-date><volume>26</volume><issue>1</issue><fpage>78</fpage><lpage>83</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Назарова Г.Б., Мершина Е.А., Лисицкая М.В., Плотникова М.Л., Баженова Д.А., Малахов П.С., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Назарова Г.Б., Мершина Е.А., Лисицкая М.В., Плотникова М.Л., Баженова Д.А., Малахов П.С.</copyright-holder><copyright-holder xml:lang="en">Nazarova G.B., Mershina E.A., Lisitskaya M.V., Plotnikova M.L., Bazhenova D.A., Malakhov P.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://medvis.rdsmedia.ru/jour/article/view/1086">https://medvis.rdsmedia.ru/jour/article/view/1086</self-uri><abstract><p>Спонтанный пневмомедиастинум, пневмоторакс, пневмоперитонеум и эмфизема мягких тканей описаны в нескольких источниках как возможные осложнения у пациентов с тяжелой формой течения COVID-19 и сопутствующим поражением легких. Данное наблюдение направлено на то, чтобы проследить динамику развития этих поражений у 3 пациентов мужского пола с наличием коморбидных состояний. Предполагаемым патофизиологическим механизмом развития данных осложнений является утечка воздуха из-за обширного диффузного альвеолярного повреждения с последующим разрывом альвеол. У всех представленных пациентов исход заболевания был благоприятен, без летальных случаев, были приведены их лабораторные данные и клиническая динамика, а также динамика изменений поражения легочной ткани.Следует отметить, что подобные состояния не являются редкими осложнениями при COVID-19 и наблюдаются в основном у пациентов мужского пола с тяжелой формой заболевания и наличием коморбидных состояний, ассоциированы с длительной госпитализацией и тяжелым прогнозом. В некоторых случаях при более легкой форме течения заболевания и положительной динамике в виде уменьшения процента поражения легких исход благоприятен и не требует дополнительных инвазивных вмешательств.</p></abstract><trans-abstract xml:lang="en"><p>Spontaneous pneumomediastinum, pneumothorax, pneumoperitoneum, and soft tissue emphysema have been recently described in several sources as possible complications in patients with severe COVID-19 and lung damage. This clinical case is dedicated to demonstrarte the development of these lesions in 3 male patients with comorbid conditions. The putative pathophysiological mechanism of these complications is air leakage due to extensive diffuse alveolar damage followed by rupture of the alveoli. All presented patients had a favorable outcome of the disease without lethal cases, their laboratory data and clinical dynamics were described.It should be noted that such conditions are not rare complications of COVID-19, and are observed mainly in male patients with severe form of the disease and the presence of comorbid conditions. Such complications are associated with long hospitalization and a severe prognosis. In some cases, with a mild course of the disease and positive dynamics in a decrease of the percentage of pulmonary lesions, the outcome is favorable, not requiring additional invasive interventions.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>пневмомедиастинум</kwd><kwd>пневмоторакс</kwd><kwd>пневмоперитонеум</kwd><kwd>covid-19</kwd><kwd>клинический случай</kwd><kwd>осложнения covid-19 пневмонии</kwd></kwd-group><kwd-group xml:lang="en"><kwd>pneumomediastinum</kwd><kwd>pneumothorax</kwd><kwd>pneumoperitoneum</kwd><kwd>COVID-19</kwd><kwd>case report</kwd><kwd>complications of&#13;
COVID-19</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена в рамках государственного задания МГУ (номер ЦИТИС 121061800142-0)</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Elhakim T.S., Abdul H.S., Romero C.P., Fuentes Y.R. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review. Br. Med. J. 2020; 13: 1–7. https://doi.org/10.1136/bcr-2020-239489</mixed-citation><mixed-citation xml:lang="en">Elhakim T.S., Abdul H.S., Romero C.P., Fuentes Y.R. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review. Br. Med. J. 2020; 13: 1–7. https://doi.org/10.1136/bcr-2020-239489</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Hamad A.M., Elmahrouk A.F., Abdulatty O.A. Alveolar air leakage in COVID-19 patients: pneumomediastinum and / or pneumopericardium. Hear. Lung. 2020; 1–2. https://doi.org/10.1016/j.hrtlng.2020.09.006</mixed-citation><mixed-citation xml:lang="en">Hamad A.M., Elmahrouk A.F., Abdulatty O.A. Alveolar air leakage in COVID-19 patients: pneumomediastinum and / or pneumopericardium. Hear. Lung. 2020; 1–2. https://doi.org/10.1016/j.hrtlng.2020.09.006</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Juárez-Lloclla J.P., León-Jiménez F., Urquiaga-Calderón J., Temoche-Nizama H. Spontaneous Pneumopericardium and Pneumomediastinum in Twelve COVID-19 Patients. Elsevier. 2020; 57: 70–96. https://doi.org/10.1016/j.arbres.2020.09.013</mixed-citation><mixed-citation xml:lang="en">Juárez-Lloclla J.P., León-Jiménez F., Urquiaga-Calderón J., Temoche-Nizama H. Spontaneous Pneumopericardium and Pneumomediastinum in Twelve COVID-19 Patients. Elsevier. 2020; 57: 70–96. https://doi.org/10.1016/j.arbres.2020.09.013</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Martinelli A.W., Ingle T., Newman J. COVID-19 and Pneumothorax: A Multicentre Retrospective Case Series. Eur. Respir. J. 2020; 56(5): 2002697. https://doi.org/10.1183/13993003.02697-2020</mixed-citation><mixed-citation xml:lang="en">Martinelli A.W., Ingle T., Newman J. COVID-19 and Pneumothorax: A Multicentre Retrospective Case Series. Eur. Respir. J. 2020; 56(5): 2002697. https://doi.org/10.1183/13993003.02697-2020</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Vidrio D.R., Vidrio D.E, Gutierrez O.J. et al. Pneumoperitoneum in a COVID-19 Patient Due to the Macklin Effect. Cureus. 2021; 13: 8–11. https://doi.org/10.7759/cureus.13200</mixed-citation><mixed-citation xml:lang="en">Vidrio D.R., Vidrio D.E, Gutierrez O.J. et al. Pneumoperitoneum in a COVID-19 Patient Due to the Macklin Effect. Cureus. 2021; 13: 8–11. https://doi.org/10.7759/cureus.13200</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Wang J., Su X. Spontaneous Pneumomediastinum: A Probable Unusual Complication of Coronavirus Disease 2019 (COVID-19) Pneumonia. Korean J. Radiol. 2020; 21: 627–628. https://doi.org/10.3348/kjr.2020.0281</mixed-citation><mixed-citation xml:lang="en">Wang J., Su X. Spontaneous Pneumomediastinum: A Probable Unusual Complication of Coronavirus Disease 2019 (COVID-19) Pneumonia. Korean J. Radiol. 2020; 21: 627–628. https://doi.org/10.3348/kjr.2020.0281</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Zhou C., Gao Ch., Xie Y., Xu M. Clinical Picture COVID-19 with spontaneous pneumomediastinum. Lancet. Infect. Dis. 2020; 3099: 310. https://doi.org/10.1016/S1473-3099(20)30156-0</mixed-citation><mixed-citation xml:lang="en">Zhou C., Gao Ch., Xie Y., Xu M. Clinical Picture COVID-19 with spontaneous pneumomediastinum. Lancet. Infect. Dis. 2020; 3099: 310. https://doi.org/10.1016/S1473-3099(20)30156-0</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Sun R., Liu H., Wang X. Mediastinal Emphysema, Giant Bulla and Pneumothorax Developed during the Course of COVID-19 Pneumonia. Korean J. Radiol. 2020; 21: 541–544. https://doi.org/10.3348/kjr.2020.0180</mixed-citation><mixed-citation xml:lang="en">Sun R., Liu H., Wang X. Mediastinal Emphysema, Giant Bulla and Pneumothorax Developed during the Course of COVID-19 Pneumonia. Korean J. Radiol. 2020; 21: 541–544. https://doi.org/10.3348/kjr.2020.0180</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Singh A., Bass J., Lindner D.H. Case Report Rare Complication of Pneumomediastinum and Pneumopericardium in a Patient with COVID-19 Pneumonia. Case Rep. Pulmonol. 2020; 3: 2–10. https://doi.org/10.1155/2020/8845256</mixed-citation><mixed-citation xml:lang="en">Singh A., Bass J., Lindner D.H. Case Report Rare Complication of Pneumomediastinum and Pneumopericardium in a Patient with COVID-19 Pneumonia. Case Rep. Pulmonol. 2020; 3: 2–10. https://doi.org/10.1155/2020/8845256</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Alharthy A., Bakirova G.H., Bakheet H., Balhamar A. COVID-19 with spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in the intensive care unit: Two case reports. Elsevier. 2020; 4: 3–5. https://doi.org/10.1016/j.jiph.2020.12.019</mixed-citation><mixed-citation xml:lang="en">Alharthy A., Bakirova G.H., Bakheet H., Balhamar A. COVID-19 with spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in the intensive care unit: Two case reports. Elsevier. 2020; 4: 3–5. https://doi.org/10.1016/j.jiph.2020.12.019</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
