ABSTRACT
Background: Coronavirus disease 19 has been associated with a plethora of different manifestations of systems affected (including pulmonary, gastro-intestinal, and thrombotic disease) and time to presentation of complications. Pneumothorax has been established as a complication in the literature. However, tension pneumothorax remains a rare presentation with higher mortality. We report a case of secondary tension pneumothorax in a patient following apparent recovery from COVID-19 pneumonitis. Case presentation: Eight days after resolution of COVID-19 pneumonitis symptoms a 51-year-old Caucasian man with no pre-existing pulmonary disease was brought into the emergency department following 48 hours of progressive shortness of breath. Further clinical assessment revealed reduced breath sounds in the right lung, BP was 116/95 mmHg and jugular venous pressure was not elevated. Chest x-ray showed right-sided tension pneumothorax with mediastinal shift. Insertion of a chest drain led to rapid resolution of symptoms and the patient was discharged following full re-expansion of the lung. Conclusion(s): The period of recovery from COVID-19 is variable. Clinicians should consider tension pneumothorax as a possible complication of COVID-19 pneumonitis in patients presenting with type 1 respiratory failure, even after resolution of pneumonitis symptoms and a considerable time period following initial contraction of COVID-19.