Patient 3
A 66-year-old male with a past medical history of hypertension, obesity and chronic kidney disease, was admitted with fever and acute confusion, secondary to type 1 respiratory failure. He was similarly managed initially with CPAP therapy and antibiotics. Admission CXR demonstrated pulmonary infiltrates and a pneumopericardium. He deteriorated rapidly and required intubation and mechanical ventilation on the same day. Subsequent CXR confirmed extensive pneumomediastinum. He suffered severe hyponatraemia and acute kidney injury requiring haemofiltration. The diagnosis of COVID-19 was confirmed by RT-PCR. He was extubated and transferred to the ward. Serial CXR confirmed the resolution of his pneumomediastinum.