<?xml version="1.0" encoding="ISO-8859-1"?><article 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">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2023000400015</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.2062</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Pneumomediastino como Complicação de Infeção SARS-CoV-2: Série de Casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Pneumomediastinum as a Complication of SARS-CoV-2 Infection: Case Series]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cunha]]></surname>
<given-names><![CDATA[Joana Gomes da]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lopes]]></surname>
<given-names><![CDATA[Andreia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Rita dos Santos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Sofia Santos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Veiga]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quental]]></surname>
<given-names><![CDATA[Bárbara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romão]]></surname>
<given-names><![CDATA[Vera]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar de Tondela-Viseu Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Viseu ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar de Tondela-Viseu Serviço de Medicina Intensiva ]]></institution>
<addr-line><![CDATA[Viseu ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2023</year>
</pub-date>
<volume>30</volume>
<numero>4</numero>
<fpage>15</fpage>
<lpage>22</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2023000400015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2023000400015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2023000400015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Apesar de raro, o pneumomediastino tem sido descrito como uma complicação não desprezível nos doentes com infeção SARS-CoV-2, o que, segundo a literatura, não parece estar relacionado com o mecanismo clássico de barotrauma pulmonar. Pretende-se, com este trabalho, alertar para esta entidade nosológica e potencial fisiopatologia, através da descrição de casos de pneumomediastino em doentes com COVID-19 e revisão dos dados disponíveis até ao momento atual.  Métodos:  Análise retrospetiva e descritiva dos casos de pneumomediastino ocorridos em doentes com COVID-19, entre janeiro e fevereiro de 2021, no serviço de Medicina Interna, de um hospital central - avaliação epidemiológica e das comorbilidades de cada doente, evolução da doença, complicações e revisão da literatura disponível até ao momento.  Resultados:  Dos 400 doentes admitidos com COVID-19 ao longo dos 2 meses em estudo, 4 desenvolveram pneumomediastino: todos do género masculino, idade entre os 68 e 81 anos, com várias comorbilidades, predominantemente cardiovasculares. Todos foram submetidos a ventilação mecânica não invasiva, sendo que três deles foram adicionalmente sujeitos a ventilação mecânica invasiva. Evoluíram desfavoravelmente, acabando por falecer.  Conclusão:  O pneumomediastino, como complicação da infeção SARS-CoV-2, revelou-se de grande gravidade, com desfecho negativo em todos os doentes identificados, importando estar atento aos fatores predisponentes, para um diagnóstico precoce e uma atuação atempada.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Even though pneumomediastinum cases are t frequent, it has been described as a non-negligible complication in patients with SARS-CoV-2 infection. According to the available literature at this moment, development of pneumomediastinum in patients with SARS-CoV-2 infection does not seem to be related to the classic mechanism of pulmonary barotrauma. This work aims to raise awareness of this nosological entity and its pathophysiology.  Methods:  The authors conducted a retrospective study of all COVID-19 cases with pneumomediastinum between January and February 2021 in an Internal Medicine ward at a Central Hospital - analysis of their comorbidities, disease evolution, complications, and a review of the available literature.  Results: From 400 patients admitted with COVID-19, in 2 months under study, 4 developed pneumomediastinum: all male, aged between 68 and 81 years, with various comorbidities, mainly cardiovascular. All were subjected to non-invasive mechanical ventilation, with three of them additionally subjected to invasive mechanical ventilation. They evolved unfavorably and ended up dying.  Conclusion: Pneumomediastinum, as a complication of SARS-CoV-2 infection, proved to be very serious, with a negative outcome in all the identified patients. It is important to be aware of predisposing factors, for early diagnosis and timely intervention.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[COVID-19/complicações]]></kwd>
<kwd lng="pt"><![CDATA[Pneumomediastino/etiologia.]]></kwd>
<kwd lng="en"><![CDATA[COVID-19/complications]]></kwd>
<kwd lng="en"><![CDATA[Mediastinal Emphysema/etiology.]]></kwd>
</kwd-group>
</article-meta>
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