Diagnosis of Spontaneous Secondary Tension Pneumothorax Following Apparent Recovery From Coronavirus Disease 2019 Pneumonitis

A Case Report

Romesh Tirimanna; James Myerson; Michael Okorie; Eleanor Dorman


J Med Case Reports. 2022;16(88) 

In This Article


The coronavirus disease 2019 (COVID-19) pandemic remains a relatively recent phenomenon with various long-term sequelae still being identified. In susceptible individuals, infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can trigger a profound inflammatory state resulting in a rapidly progressing pneumonitis and ground glass opacification on chest x-ray.[1] COVID-19 pneumonitis is treated with oxygen and corticosteroids in addition to other forms of pharmacological therapy.

This patient was admitted at a time when daily case numbers for COVID-19 exceeded 40,000 and daily deaths exceeded 900 in the UK. The ubiquity of COVID-19 pneumonitis risked causing tunnel vision among many clinicians at the time. Tension pneumothorax, by contrast, is a relatively uncommon presentation with high mortality. One systematic review estimated the mortality of tension pneumothorax at 6.7% in unventilated patients, increasing up to 22.7% in ventilated patients.[2] This case report aims to emphasize the importance of recognizing tension pneumothorax as a possible complication of COVID-19 pneumonitis even after apparent recovery.