Spontaneous pneumomediastinum occurs in COVID-19 patients and for those who are older is associated with higher mortality rates, according to a study published August 31 in Academic Radiology.
The condition is described as free air within the mediastinum not caused by trauma and tends to be rare, noted a team led by Dr. Anisa Chowdhary of Institute of Nuclear Medicine and Allied Sciences in New Delhi.
"Although the imaging findings and complications of SARS-CoV-2 infection have been reported many times, there are few reports of the prevalence and outcomes of patients with spontaneous pneumomediastinum," the team wrote.
Chowdhary's group evaluated three cases of spontaneous pneumomediastinum and also reviewed 22 case reports that included 35 patients. It found that the condition occurs in COVID-19 patients with a mean age of 56 years and was associated with a 28.5% mortality rate -- a contrast to cases of spontaneous pneumomediastinum not related to COVID-19, which tend to occur in younger people who recover well.
"Spontaneous pneumomediastinum in COVID-19 patients occurs in older patients and is potentially associated with a higher mortality rate," the group concluded. "Further studies are necessary to assess its role as a prognostic marker of poor outcome."
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
