OBJECTIVES In this study, we aimed to establish risk factors for primary spontaneous pneumomediastinum associated with Coronavirus disease 2019 (COVID-19) and reveal those which are significant. METHODS The study included 62 patients with primary spontaneous pneumomediastinum who presented to our hospital between 11 March 2020, the date of the first-reported COVID-19 case in our country, and 3 January 2021. Of these, 14 patients (22.6%) had COVID-19 and 48 patients (77.4%) did not have COVID-19. RESULTS Of the 62 patients included in the study, 41 (66.1%) were male and 21 (33.9%) were female. The mean age was 28.90 ± 16.86 (range, 16–84) years. The most common symptom at admission was chest pain (54.8%). The mean age of the patients with COVID-19 was 39.35 ± 23.04 years and that of the patients without COVID-19 was 25.85 ± 13.45 years (P < 0.001). In receiver-operating characteristic curve analysis, the area under the curve for age was 0.785 (95% confidence interval: 0.648–0.922) and the optimal cut-off value was 24 years for COVID-19-positive patients. The highest sensitivity and specificity values were 0.857 and 0.729. Twelve (85.79%) of the COVID-19-positive primary spontaneous pneumomediastinum patients were aged 24 years or older (P < 0.001). Five patients (8.1%) had positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test but no abnormal findings on computed tomography. CONCLUSIONS Having an age of more than 24 years was associated with a higher prevalence of pneumomediastinum in COVID-19 patients and emerged as an important risk factor. Multicentre studies with more cases are needed to determine whether pneumomediastinum is associated with additional other risk factors related to COVID-19.

中文翻译：

---

在 COVID-19 大流行期间，原发性自发性纵隔气肿危险因素是否发生了变化？

目的 在本研究中，我们旨在确定与 2019 年冠状病毒病 (COVID-19) 相关的原发性自发性纵隔气肿的危险因素，并揭示那些具有重要意义的因素。方法 该研究纳入了 2020 年 3 月 11 日（我国首次报告 COVID-19 病例之日）至 2021 年 1 月 3 日到我院就诊的 62 例原发性自发性纵隔气肿患者。其中，14 例患者（22.6%） COVID-19 和 48 名患者 (77.4%) 没有 COVID-19。结果 纳入研究的 62 名患者中，41 名（66.1%）为男性，21 名（33.9%）为女性。平均年龄为 28.90 ± 16.86（范围，16-84）岁。入院时最常见的症状是胸痛（54.8%）。COVID-19 患者的平均年龄为 39.35 ± 23.04 岁，而未感染 COVID-19 的患者的平均年龄为 25.85 ± 13.45 岁（P <; 0.001)。在接受者操作特征曲线分析中，年龄曲线下面积为 0.785（95% 置信区间：0.648-0.922），COVID-19 阳性患者的最佳截止值为 24 岁。最高灵敏度和特异性值为 0.857 和 0.729。12 名 (85.79%) 的 COVID-19 阳性原发性自发性纵隔气肿患者年龄在 24 岁或以上 (P < 0.001)。5 名患者（8.1%）的严重急性呼吸综合征冠状病毒 2 聚合酶链反应检测呈阳性，但计算机断层扫描未发现异常。结论 年龄超过 24 岁与 COVID-19 患者的纵隔气肿患病率较高相关，并成为一个重要的危险因素。