Spontaneous Tension Pneumothorax is a Rare and Life-Threatening Complication of COVID-19 Infection: A Case Report and Literature Review
Abstract
The coronavirus disease is a recent pandemic infection, with the first case being discovered in Wuhan, China, in December 2019. Iran is one of the countries that has been afflicted by this pandemic. A 34-year-old man with no history of pre-existing disease and smoking has been hospitalized in another hospital for the past two weeks due to COVID-19 infection and symptoms of fever, cough, and dyspnea. He received standard medical treatments in that hospital. After two weeks, he was discharged from the hospital with his consent. In the afternoon of the same day, he came to the emergency department of our hospital with severe dyspnea. Tension pneumothorax in the left hemithorax, pulmonary collapse, and shifting mediastinal elements to the contralateral side were observed in his chest x-ray. Tension pneumothorax is an unusual symptom in patients with SARS-CoV-2. Pneumothorax has been reported in 1% of COVID-19 patients who need hospitalization, 2% of those who need intensive care unit admission, and 1% of those who die from the infection. Spontaneous pneumothorax must be ruled out in COVID-19 patients with dyspnea and chest pain, tachycardia, tachypnea, or hypoxemia. It is critical to be familiar with these symptoms to make an accurate diagnosis and treatment plan. A thorough physical examination and serial chest X-rays can be helpful tools in the diagnosis and management of the disease.
2. Panahi L, Yaghubi T, Amiri M, Khorasgani AE, Pouy S. Clinical Characteristics of Patients Infected with Coronavirus Disease 2019 (COVID-19) in Iran: A Retrospective Cohort Study. Iran Red Crescent Med J. 2021;23(3).
3. Gidaro A, Samartin F, Brambilla AM, Cogliati C, Ingrassia S, Banfi F, et al. Correlation between continuous Positive end-expiratory pressure (PEEP) values and occurrence of Pneumothorax and Pneumomediastinum in SARS-CoV2 patients during noninvasive ventilation with Helmet. Sarcoidosis Vasc Diffus Lung Dis. 2021;38(2).
4. Martinelli AW, Ingle T, Newman J, Nadeem I, Jackson K, Lane ND, et al. COVID-19 and pneumothorax: A multicentre retrospective case series. Eur Respir J [Internet]. 2020;56(5). Available from: http://dx.doi.org/10.1183/13993003.02697-2020
5. Umar Shahzad M, Han J, Ramtoola MI, Lamprou V, Gupta U. Spontaneous Tension Pneumothorax as a Complication of COVID-19. Case Rep Med. 2021;2021.
6. Riahi T, Shokri S. Clinical and Laboratory Predictors of Mortality in Hospitalized COVID-19 Patients. Iran Red Crescent Med J [Internet]. 2021 Apr 15;23(5). Available from: https://ircmj.org/index.php/IRCMJ/article/view/531
7. Akdogan RE, Mohammed T, Syeda A, Jiwa N, Ibrahim O, Mutneja R. Pneumothorax in Mechanically Ventilated Patients with COVID-19 Infection. Case Reports Crit Care. 2021;2021.
8. Spiro JE, Sisovic S, Ockert B, Böcker W, Siebenbürger G. Secondary tension pneumothorax in a COVID-19 pneumonia patient: a case report. Infection [Internet]. 2020;48(6):941–4. Available from: https://doi.org/10.1007/s15010-020-01457-w
9. Yasukawa K, Vamadevan A, Rollins R. Images in clinical tropical medicine bulla formation and tension pneumothorax in a patient with COVID-19. Am J Trop Med Hyg. 2020;103(3):943–4.
10. Khurram R, Johnson FTF, Naran R, Hare S. Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection. BMJ Case Rep. 2020;13(8):11–4.
11. Miró Ò, Llorens P, Jiménez S, Piñera P, Burillo-Putze G, Martín A, et al. Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019. Chest. 2021;159(3):1241–55.
12. Raoof S, Nava S, Carpati C, Hill NS. High-Flow, Noninvasive Ventilation and Awake (Nonintubation) Proning in Patients With Coronavirus Disease 2019 With Respiratory Failure. Chest [Internet]. 2020;158(5):1992–2002. Available from: https://doi.org/10.1016/j.chest.2020.07.013
13. Mayank Vats, Bassam, Mahboub, Walid Mahmood, Deepa Khandelwal S vats. COVID19- Spontaneous Pneumomediastinum On Noninvasive Ventilation in Interstitial Lung Disease Patient MAR Pulmonology. MAR Pulmonol. 2021;4:1–9.
14. Sun R, Liu H, Wang X. Mediastinal emphysema, giant bulla, and pneumothorax developed during the course of COVID-19 Pneumonia. Korean J Radiol. 2020;21(5):541–4.
Files | ||
Issue | Vol 61 No 5 (2023) | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/acta.v61i5.13488 | |
Keywords | ||
Coronavirus disease 2019 (COVID-19) Corona virus Pneumothorax Tension pneumothorax Spontaneous pneumothorax Case report |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |