Introduction:

Spontaneous pneumomediastinum and pneumopericardium in patients with COVID-19 may occur unusually and cause a torripid clinical evolution. We present paraguay's first clinical report of a patient with pneumomediastinum and pneumopericardium associated with COVID-19 pneumonia.

Case presentation:

39-year-old patient with COVID-19 pneumonia had dyspnoea and persistent chest pain and a torrid clinical evolution, was valued at day twenty-six of its evolution by pneumology, with a presence of air in mediastinum and pericardium at primary controls by initial treating physicians. Conservative and symptomatic medical treatment was instituted with good response and favorable evolution.

Discussion:

Spontaneous pneumomediastinum and pneumopericardium can be caused by alveolar rupture due to alveolar susceptibility by the cytokine storm common in COVID-19, thus the air can dissociate and drain the vascular peribronchial sheath and access the mediastinum or other spaces, being able to occur at any stage of the disease, so the serial and correctly analyzed tomographic controls are crucial for its detection.

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