Spontaneous Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema in COVID-19 Pneumonia: A Rare Case and Literature Review


East Florida


Kendall Regional Medical Center

Document Type

Case Report

Publication Date



sars-cov-2, coronavirus infections, COVID-19


Critical Care | Infectious Disease | Internal Medicine | Respiratory Tract Diseases | Virus Diseases


Spontaneous pneumomediastinum (SPM) and pneumothorax (PNX) unrelated to positive pressure ventilation has been recently reported as an unusual complication in cases of severe COVID-19 pneumonia. The presumed pathophysiological mechanism is diffuse alveolar injury leading to alveolar rupture and air leak. We present a case of COVID-19 pneumonia complicated on day 13 post admission by SPM, PNX and subcutaneous emphysema in a patient with no identifiable risk factors for such complication. The patient received medical treatment for his COVID-19 infection without the use of an invasive or non-invasive ventilator. Moreover, he is a non-smoker with no lung comorbidities and never reported a cough. He was eventually discharged home in stable condition. A comprehensive literature review revealed 15 cases of SPM developing in patients with COVID-19 pneumonia.


This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ.

Publisher or Conference

BMJ Case Reports