Table 1.

Summary of pneumothorax or/and pneumomediastinum in patients infected with SARS-CoV-2

Reference	Country	Gender/age (years)	Comorbidities	Symptoms	Radiological findings	Complications	Onset of symptoms (days) until outcome	Management	Outcome
Pneumothorax
Aiolfi et al.25	Italy	M/56	Active smoking	Fever, cough, and respiratory distress	CT: bilateral, peripheral GGOs. CXR: left-side pneumothorax	None	12+	Intubation at the ICU. Three-port left-side thoracoscopy and bleb resection	Favorable
Aiolfi et al.25	Italy	M/70	None	Fever, fatigue, and respiratory distress	CT: bilateral, subpleural GGOs. CXR: left-side pneumothorax	None	5+	Intubation at the ICU. Three-port left-side thoracoscopy and bleb resection	Favorable
Corrêa Neto et al.20	Brazil	F/80	Hypertension and ischemic heart disease, currently using clopidogrel, aspirin, losartan, and carvedilol	Dry and persistent cough, fever, SOB, and diffuse abdominal pain	CT: ground-glass pattern in the bilateral pulmonary parenchyma, pneumothorax on the right, and extensive pneumoperitoneum, with free intracavitary fluid	Refractory septic shock	12+	Hydration, orotracheal intubation, broad-spectrum antibiotic therapy, and right chest drainage	Died
Flower et al.24	United Kingdom	M/36	Childhood asthma and a 10-pack-year history of smoking	Fever, dry cough, SOB, and left-sided pleuritic chest pain	CXR: large left-sided pneumothorax with mediastinal shift and radiological signs of tension. The right lung displayed widespread patchy consolidative changes. CT: widespread areas of patchy consolidation, with associated bullae	None	23	Emergency needle decompression, and a chest drain	Favorable, discharged after 2 days
Hollingshead et al.21	USA	M/50	NR	SOB	CT: diffuse GGOs throughout the chest but also a 10-cm loculated posterior right pneumothorax	None	NR	Chest tube	Favorable
Rohailla et al.22	Canada	M/26	None	Sudden-onset right-sided pleuritic chest pain and progressive SOB	CXR: large right pneumothorax with complete collapse of the right lung without mediastinal shift	None	5	Small catheter chest drain	Favorable, discharged after 2 days
Spiro et al.23	Germany	M/47	Splenectomy, and HIV under antiretroviral therapy	Fever, dry cough, SOB, and stenocardia	CT bipulmonary GGOs and consolidations with a multi-lobar, peripheral, and dorsal distribution. Right-sided tension pneumothorax	None	34	Morphine and azithromycin. Then, chest tube through open thoracotomy	Favorable, discharged after 20 days
Sun et al.15	China	M/38	None	Fever and cough	CT: GGOs in the left lower lobe. Then, lesions turned into consolidation. Emphysema, giant bulla, small pneumothorax, and pleural effusion	Dyspnea and severe hypoxemia. Acute respiratory distress syndrome	34+	High-flow nasal cannula. Then, noninvasive mechanical ventilation at the ICU	NR
Xiang et al.16	China	M/67	Coronary artery bypass, chronic pulmonary diseases (obsolete pulmonary tuberculosis, chronic bronchitis, and emphysema)	Dyspnea, fatigue, and mild diarrhea	CXR: extensive air-space opacities in bilateral lungs. Subcutaneous emphysema, mediastinal emphysema and a small amount of pneumothorax on both sides	Sinus bradycardia and left ventricular enlargement with ejection fraction 20%	27	Invasive ventilation at the ICU. Then, prone position ventilation, vasoconstrictor, antibacterial, and antiviral therapy. Chest closed drainage	Died, 12 days after admission
Pneumomediastinum
Kolani et al.27	Morocco	F/23	NR	asymptomatic	CT: inconspicuous GGOs in the lower left inferior lobe and a small amount of air in the mediastinum without any fluid infiltration	None	10+	Azithromycin and chloroquine	Favorable, discharged after 10 days
Lacroix et al.7	France	M/57	None	severe acute dyspnea, fever, cough, breathlessness, diarrhea, and anosmia	CXR: diffuse subcutaneous emphysema and bilateral consolidations. CT: pneumomediastinum, subcutaneous emphysema, consolidations, GGOs and crazy paving	NR	14+	Intubation for mechanical ventilation	NR
Lei et al.28	China	M/64	NR	Fever and fatigue	CT: progressive resolution of the patient’s pneumonic lesions and spontaneous pneumomediastinum in the anterior mediastinum	None	24+	NR	NR
Mohan et al.17	USA	M/49	Hypertension and type 2 diabetes	Fever, cough, SOB, and anosmia	CXR: bilateral patchy infiltrates. CT: severe pneumomediastinum with extensive subcutaneous emphysema	Nausea and vomiting	18	Ceftriaxone, doxycycline, steroids, enoxaparin sodium, and hydroxychloroquine and noninvasive supplemental oxygen	Favorable, discharged after 15 days
Wang et al.29	China	F/36	Mastitis	Fever, cough, and bloody sputum, and SOB	CT: multiple diffuse patchy consolidation areas and GGOs in both lungs. There was interlobular septal thickening with pleural effusion and bronchiectasis	Respiratory failure and acute respiratory distress syndrome	14	Combined antiviral drugs, anti-inflammatory drugs, and supportive care	Died after 2 days
Zhou et al.4	China	M/38	NR	Fever, cough, and headaches	CT: multiple GGOs with bilateral parenchymal consolidation and interlobular septal thickening, subcutaneous emphysema, and pneumomediastinum	SOB and exertional angina	31	Broad-spectrum antibiotic therapy, recombinant human interferon alfa-1b, and supplemental oxygen	Favorable, discharged after 30 days
Pneumothorax and pneumomediastinum
López Vega et al.8	Spain	F/84	Anticoagulation due to prosthetic valve replacement, renal failure, stage C heart failure with preserved ejection fraction, hypertension, and hypercholesterolemia	Fever, cough, and dyspnea	CT: right partial hydropneumothorax, left full hydropneumothorax, and pneumomediastinum. Pulmonary involvement by COVID-19	Progressive deterioration of respiratory function, atelectasis of the left lung until developing a white lung	18	Hydroxychloroquine, ceftriaxone, methylprednisolone, and oxygen supplementation	Died
López Vega et al.8	Spain	M/67	NR	Fever and dyspnea	CXR: bilateral opacities with multi-lobar affectation. CT: a pneumothorax chamber and pneumomediastinum	Decreased renal function, worsening respiratory function, and multiple organ failure	18	Piperacillin/tazobactam and azithromycin at the ICU, and pleural drainage tube	Died
López Vega et al.8	Spain	M/73	Basal cell epithelioma, obstructive sleep apnea, obesity, and depression under pharmacological treatment	Fever and dyspnea	CXR: alveolar opacity with a bibasal air bronchogram. CT: extensive bilateral involvement by coronavirus, and a minimal chamber of pneumomediastinum	Progressive deterioration	20	Hydroxychloroquine, azithromycin, tocilizumab, methylprednisolone, and oxygen support. Then, anticoagulant therapy and noninvasive ventilatory support with continuous positive airway pressure	Died 15 days after admission
Ucpinar et al.19	Turkey	F/82	None	Fever, SOB, and persistent cough	CT: widespread bilateral GGOs, predominantly in lower lobes. In addition, pneumomediastinum, left-sided massive pneumothorax, and subcutaneous emphysema in the neck posterior thoracic wall were identified	None	11+	Hydroxychloroquine, oseltamivir, ceftriaxone, and a chest tube	Favorable, discharged after 11 days
Wang et al.18	China	M/62	None	Fever, cough, and dyspnea	CT: multiple GGOs with parenchymal consolidation, pneumothorax on the right, combined with pneumomediastinum, and subcutaneous emphysema	None	47	Oxygen therapy, lopinavir/ritonavir, as well as antibiotics and steroid therapy	Favorable, discharged

CT = computed tomography; CXR = chest X-ray; GGOs = ground-glass opacities; ICU = intensive care unit; NR = no reported; SOB = shortness of breath.