• Rajan Pooni, Gargi Pandey, and Saniath Akbar.
• Gastroenterology, Barts Health NHS Trust, London, UK r.pooni@nhs.net.
• BMJ Case Rep. 2020 Aug 11; 13 (8).

AbstractThe novel coronavirus (COVID-19) has emerged as a new pathogen responsible for an atypical viral pneumonia, with severe cases progressing to an acute respiratory distress syndrome. In our practice, we have observed patients admitted with COVID-19 pneumonia developing worsening hypoxaemic respiratory failure prompting the need for urgent endotracheal intubation. Here, we present a case of a patient admitted with severe COVID-19 pneumonia who required continuous positive airway pressure support following acute deterioration. However, with the patient requiring an increasing fraction of inspired oxygen (FiO2), a prompt CT pulmonary angiogram scan was performed to exclude an acute pulmonary embolism. Surprisingly, this revealed a pneumomediastinum. Following a brief admission to the intensive care unit, the patient made a full recovery and was discharged 18 days post admission.© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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