Secondary spontaneous pneumothorax as post COVID-19 sequela

Moli Jai Jain, Vaishnavi Dilip Yadav

PAMJ. 2021; 39:190. Published 08 Jul 2021 | doi:10.11604/pamj.2021.39.190.30473

A 48-year-old male patient with a significant history of hypertension for 8 years and newly diagnosed diabetes was admitted on account of fever and difficulty in breathing from 15 days, initially exertional but later present at rest. A nasopharyngeal swab taken for RT-PCR testing was positive for COVID-19. Following admission, he was placed on 15 L O2/ min because of not maintaining saturation later put on a mechanical ventilator on pressure support mode with PEEP 8 cm H2O and 80% FiO2 for the next 8 days. HRCT thorax (A) revealed multiple areas of ill-defined ground-glass opacities with septal thickening and few areas of consolidation. There are multiple air-filled cystic spaces (red arrow) in sub-pleural spaces of lateral segment of right middle and lower lobes there is evidence of fibro-bronchiectatic changes as a symptom of Post-COVID sequela with CT severity score 23/25 (severe) and CORAD-6. Later he was put on BiPAP support for 19 days and gradually weaned off to 12L O2/ min via face mask connecting to re-breathing bag. Soon he developed secondary spontaneous Pneumothorax visible on Chest X-ray (B) because of which pig tail inter-costal drainage was done in 4th intercostal space in anterior axillary line. Post COVID-19 complications are become more evident and chest imaging plays an important role in early screening and monitoring such cases.
Corresponding author
Vaishnavi Dilip Yadav, Department of Cardiovascular and Respiratory Physiotherapy Sciences, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India (

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