Spontaneous pneumothorax secondary to emphysematous bullae as sequelae of severe covid-19 pneumonia: case report

Abstract

Introduction: in December 2019, a new respiratory virus of the coronavirus family was identified in the province of Wuhan China, it rapidly spread worldwide, causing an impact on morbidity and mortality secondary to respiratory diseases. The case of spontaneous pneumothorax in a severe post-COVID 19 patient is presented, the low number of reported cases presenting this type of complications is remarkable. Objective: to describe a clinical case of spontaneous pneumothorax secondary to the formation of emphysematous bullae in a patient who presented severe respiratory infection by SARSCOV2. Materials and Methods: presentation of a clinical case, descriptive, retrospective study. Results: male patient, 66 years of age with no significant pathological history, does not report exposure to biomass fuels or tobacco, entered the respiratory isolation area of ​​one of the main container centers for COVID-19 patients in the City of Ambato - Ecuador for presenting respiratory symptoms of several days of evolution, confirming by means of RT - PCR a case of pneumonia due to COVID 19, it was classified as severe affectation after the pulmonary radiographic evaluation for which he had a prolonged stay, due to this; He was discharged with significant pulmonary sequelae of the interstitial lung disease secondary to SARSCOV2 infection, for which he required home oxygen permanent use. After more than 20 days after hospital discharge, he was readmitted for acute respiratory failure. After ruling out nosocomial respiratory infection and pulmonary thromboembolism, spontaneous pneumothorax was identified as the cause of the symptoms, evolving favorably after chest tube placement, and discharging this time without the need for supplemental oxygen. Conclusion: early and late complications secondary to COVID 19 are an issue of vital importance within the hospital setting and the general management of this type of patients. An adequate assessment and timely intervention in patients with severe disease secondary to this pathology is essential to reduce morbidity and mortality from the virus.