Pneumothorax in a Patient Hospitalized for COVID-19, A Case Report and Literature Review

Abstract

SARS-CoV-2 was first identified at the end of 2019, in the Wuhan region (China), subsequently spreading worldwide with a major impact on health and economic system. A pneumothorax is a rare complication, affecting between 1–2% of SARS-CoV-2 cases. Pneumomediastinum is even rarer. Pneumothorax in the context of SARS-CoV-2 infection mainly occurs in patients with a severe form of the infection and requiring mechanical ventilation. This type of ventilation makes it possible to impose high positive expiratory pressures which can be complicated by pneumothorax when patients present with a lack of compliance secondary to fibrosis. Nevertheless, cases under conventional ventilation including without oxygen therapy are possible, suggesting that SARS-CoV-2 infection could be an independent risk factor for pneumothorax. Therefore, any worsening of the respiratory picture should evoke a pneumothorax. The management of pneumothorax secondary to SARS-CoV-2 pneumonia is usual. Placement of a chest drain could increase the risk of aerosol dissemination. We report the case of a pneumothorax occurring in a non-smoking patient hospitalized in intensive care for treatment of a serious SARS COV 2.