Development of a large spontaneous pneumothorax after recovery from mild COVID-19 infection

BMJ Case Rep. 2021 Jan 18;14(1):e238863. doi: 10.1136/bcr-2020-238863.


A previously healthy 37-year-old man presented with fevers and myalgias for a week with a minimal dry cough. Initial SARS-CoV-2 nasopharyngeal testing was negative, but in light of high community prevalence, he was diagnosed with COVID-19, treated with supportive care and self-quarantined at home. Three days after resolution of all symptoms, he developed sudden onset chest pain. Chest imaging revealed a large right-sided pneumothorax and patchy subpleural ground glass opacities. IgM and IgG antibodies for SARS-CoV-2 were positive. His pneumothorax resolved after placement of a small-bore chest tube, which was removed after 2 days.This case demonstrates that patients with COVID-19 can develop a significant pulmonary complication, a large pneumothorax, despite only minimal lower respiratory tract symptoms and after resolution of the original illness. Medical professionals should consider development of a pneumothorax in patients who have recovered from COVID-19 and present with new respiratory symptoms.

Keywords: adult intensive care; pneumonia (infectious disease); pneumonia (respiratory medicine); pneumothorax.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adult
  • COVID-19 / complications*
  • COVID-19 / physiopathology
  • COVID-19 Serological Testing
  • Chest Pain / physiopathology
  • Chest Tubes
  • Convalescence*
  • Cough / physiopathology
  • Dyspnea / physiopathology
  • Fever / physiopathology
  • Humans
  • Male
  • Myalgia / physiopathology
  • Pneumothorax / diagnostic imaging
  • Pneumothorax / etiology*
  • Pneumothorax / physiopathology
  • Pneumothorax / therapy
  • Radiography, Thoracic
  • SARS-CoV-2
  • Severity of Illness Index
  • Thoracostomy
  • Tomography, X-Ray Computed