key: cord-288174-w7rw9bej
authors: Shirai, Tsuyoshi; Mitsumura, Takahiro; Aoyagi, Kei; Okamoto, Tsukasa; Kimura, Moe; Gemma, Taku; Shigematsu, Takaaki; Takahashi, Junichi; Azuma, Seishin; Yoshizuka, Riku; Sasaki, Hirokazu; Urushibata, Nao; Ochiai, Kanae; Hondo, Kenichi; Morishita, Koji; Aiboshi, Junichi; Otomo, Yasuhiro; Miyazaki, Yasunari
title: COVID-19 pneumonia complicated by bilateral pneumothorax: a case report
date: 2020-09-24
journal: Respir Med Case Rep
DOI: 10.1016/j.rmcr.2020.101230
sha: 
doc_id: 288174
cord_uid: w7rw9bej

BACKGROUND: Pneumothorax is a rare but life-threatening complication associated with pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CASE PRESENTATION: Informed consent was obtained from the patient himself.A 50-year-old man presented with a 9-day history of fever, cough, and dyspnoea. He was diagnosed with coronavirus disease 2019 (COVID-19) pneumonia and was admitted to the Medical Hospital, Tokyo Medical and Dental University. Chest CT showed diffuse patchy ground-glass opacities (GGOs). His state of oxygenation deteriorated, and mechanical ventilation was initiated on day 4 after admission (12(th) day from onset). He improved gradually and was weaned from ventilation on day 15. Sudden onset of bilateral pneumothorax occurred on day 21 with severe respiratory failure, and chest CT revealed pneumatocele formation on both lower lobes. CONCLUSIONS: Pneumothorax is a notable complication in cases of severe COVID-19 pneumonia, especially in those who require positive-pressure ventilation.

In early 2020, inf ection caused by se vere acute respiratory 46 syndrome coronavirus 2 (SARS-CoV-2) became a pandemic. The 47 outbreak also occurred in Japan, especially in urban areas with 48 high population densities [1] . According to a report analys ing the 49 clinical characteristics of 1099 patients in China, 15.7% exhibited 50 severe pneumonia, and 2.3% needed invasive mechanical 51 ventilation [2] . As several cases have been reported, pneumothorax is a 106 rare but lif e-threatening complication of COVID-19 pneumonia [8, 9] . 

Clinical Characteristics of Coronavirus 200 Disease 2019 in China

Spontaneous pneumothorax and 202 subcutaneous emphysema in COVID-19 patient: Case report

Pneumothorax in a COVID-19 Pneumonia 206 Patient: A Case Report

Secondary Tension Pneumothorax in a 209 COVID-19 Pneumonia Patient: A Case Report. Inf ection

Clinical Course and Outcomes of Critically Ill Patients 219 W ith SARS-CoV-2 Pneumonia in W uhan

Analysis of 92 Deceased Patients W ith COVID-19

Distress Syndrome in Critically Ill Patients W ith Severe Acute 228

Critic ally Ill 231