Pneumothorax and pneumomediastinum in COVID-19: A case series

Am J Med Sci. 2022 Jun;363(6):548-551. doi: 10.1016/j.amjms.2020.11.024. Epub 2020 Nov 26.


COVID- 19 has become a major pandemic affecting more than 11 million people worldwide. Common radiological manifestations of COVID-19 include peripheral based ground-glass or consolidative opacities; however, pneumothorax and pneumo-mediastinum are very rare manifestations; even more so within patients not on mechanical ventilation. We present a case series of 5 patients with COVID-19 who either presented with or developed spontaneous pneumothorax or pneumo-mediastinum within the course of hospitalization. With the exception of one patient, all other patients developed pneumothorax as a late manifestation in their illness; more than 10 days after initial symptom onset in COVID-19. From within this case series, all patients who developed spontaneous pneumothorax or pneumo-mediastinum during hospitalization subsequently succumbed to the illness. Spontaneous pneumothorax or pneumo-mediastinum may be an important late manifestation in COVID-19; even in spontaneously breathing patients. This may be related to development of cystic changes within the lung parenchyma. Although the clinical relevance of this finding is unknown; in our series, it portended a worse prognosis in the majority of patients.

Keywords: COVID-19; Pneumothorax; SARS- COV-2.

Publication types

  • Case Reports
  • Review

MeSH terms

  • COVID-19* / complications
  • Humans
  • Mediastinal Emphysema* / diagnostic imaging
  • Mediastinal Emphysema* / etiology
  • Pandemics
  • Pneumothorax* / diagnostic imaging
  • Pneumothorax* / etiology
  • SARS-CoV-2