Abstract
Introduction:Severeacuterespiratorysyndromecoronavirus2(SARS-CoV-2)SARS-CoV-2isanovelvirusfirstcasereportedinWuhan,China.Nowhasspreadtorestoftheworldinfectingmorethan1,000,000populationworld-wide.Sinceitisanoveldiseaseveryfewisknownaboutthediseaseanditseffectonpatients.Furthermore,subcutaneousemphysemaisanuncommoncomplicationofSARS-CoV-2pneumonia.Here,wediscussafatalcaseofSARS-CoV-2pneumoniawithsubcutaneousemphysema.Patientconcerns:A66-year-oldfemale,diagnosedasSARS-CoV-2with60-70%fibrousofbothlungdevelopedextensiveair-spaceopacities,pneumoniaandsubcutaneousemphysemawhichwasconfirmedbyxraychest.Subcu-taneousemphysemawasfoundinneck,bilateralchestwalls,andbothupperlimbs,extendingtillabdomenwallandgroin.Diagnosis:ThispatientwasdiagnosedtohaveSARS-CoV-2infectionafterlaboratory-confirmationbyReverseTranscriptionPolymeraseChainReaction(RTPCR),atthetimeofdiagnosisofSARS-CoV-2patienthaddeveloped60-70%fibrosisofbothlungswhichwasconfirmedbyCom-puterizedTomography(CT)oflungFigure1,patienthadanunderlyingcomorbidconditionofDiabetesMellitus(DM)andsystematicHyperTension(HT).PatientonthecourseofillnessdevelopedPneumoniaandsubcutaneousemphysema,whichwasconfirmedbychestX-ray.Interventions:ShewasmanagedinitiallywithNon-ReBreatherMask(NRBM)with15litresofoxygen,withwhichshewasabletomaintainOxygenSatura-tion(spo2)of98%,lateronthecourseofillnessherrespiratorydistressstartedtoworsenandshewasconnectedtoBilevelPositiveAirwayPressure(BiPAP)evenwiththatherconditionstartedtodeterioratesoshewasshiftedtoIntensiveCareUnits(ICU)foradvancelifesupportandcareintheICU,shewasconnectedtoNon-invasiveventilation(NIV),duringthehospitalizationshereceivedvasodilators,antibacterial,steroids,anti-coagulantsandantiviraltherapy.Outcomes:Shediedonthetenthdayofcourseofhospitalstay.SubcutaneousemphysemamayoccurinpatientswithSARS-CoV-2infectionasararecomplication