Combined spontaneous pneumothorax, pneumomediastinum, and subcutaneous emphysema in a coronavirus disease-2019 pneumonia patient with previously healthy lungs

Breathlessness was the common presenting symptom, but combined spontaneous–pneumothorax–pneumomediastinum–subcutaneous emphysema (SPPSE) is not known complication of coronavirus disease-2019 (COVID-19) pneumonia. We are report a case of CSPPSE in a male adult with previously healthy lungs infected with COVID-19 pneumonia. On May 16, 2020, he was presented to the Emergency Department of Hamad General Hospital, complaining of fever, leukocytosis, and normal CRP. Chest X-ray showed mild COVID-19-related pneumonia. He was started on the local Qatari-recommended protocol for COVIMD-19. Suddenly, his oxygen saturation was deteriorated and transferred to the medical intensive care unit where he had noninvasive ventilation. Chest X-ray showed right pneumothorax, but there was no evidence of pneumomediastinum or subcutaneous emphysema. On May 30, chest computed tomography was conducted and did not show any evidence of chronic lung diseases that can produce CSPPSE. Finally, on June 13, the patient was labeled as recovered COVID-19 patient. CSPPSE is a complication of COVID-19 pneumonia, even in previously normal lungs.