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. 2020 Jun 1;7(7):001742.
doi: 10.12890/2020_001742. eCollection 2020.

COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad

Erika Poggiali  1 , Andrea Vercelli  1 , Teresa Iannicelli  1 , Valentina Tinelli  1 , Laura Celoni  1 , Andrea Magnacavallo  1
Affiliations

COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad

Erika Poggiali et al. Eur J Case Rep Intern Med. .

Abstract

We describe the case of a male patient admitted to our emergency department during the Italian COVID-19 epidemic, for progressive worsening dyspnoea. A diagnosis of pneumothorax and diffuse interstitial lung involvement was promptly made by lung ultrasound and confirmed by an HRCT scan. A chest CT scan also showed diffuse emphysema, as observed in chronic obstructive pulmonary disease (COPD), and small consolidations in the lower lobes, suggestive for COVID-19 pneumonia. A chest tube was immediately inserted in the emergency room with complete resolution of the dyspnoea. A nasopharyngeal swab for 2019-nCoV was positive. Unfortunately, the patient died from COVID-19-related acute respiratory distress syndrome after 48 days of hospitalization.

Learning points: Coronavirus disease (COVID-19) can cause death from severe acute respiratory distress syndrome (ARDS).Pneumothorax is a common complication of chronic obstructive pulmonary disease (COPD).The combination of COVID-19, COPD and pneumothorax can prove fatal.

Keywords: ARDS; COPD; COVID-19; dyspnoea; pneumonia; pneumothorax.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
HRCT of the chest at admission showing a left pneumothorax with complete collapse of the unilateral pulmonary lobe, and diffuse paraseptal, centrilobular and panlobular emphysema with ground-glass opacities and small consolidations in the right lobe
Figure 2
Figure 2
Chest x-ray after chest tube placement in the emergency room showing complete resolution of the pneumothorax and evidence of small multiple consolidations in the right middle-lower lobe
Figure 3
Figure 3
Chest x-ray showing recurrence of the left pneumothorax with a closed chest tube, and the worsening of multiple small consolidations in both pulmonary lobes
Figure 4
Figure 4
HRCT showing complete resolution of the left pneumothorax (A) and worsening of COVID-19 pneumonia with ground-glass opacities, a crazy-paving pattern and diffuse small consolidations in both pulmonary lobes (B)
Figure 5
Figure 5
Chest x-ray showing bilateral, diffuse lung opacities involving all pulmonary quadrants
See this image and copyright information in PMC

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