Fig. 2.

53 year-old female triathlon runner with severe COVID-19 infection and multiple complications. On the day of presentation and PCR testing, AP portable radiograph (A) shows ill-defined airspace opacities in the lower lungs and small pleural effusions. The patient was intubated on hospital day (HD) 3 with repeat AP portable radiograph (B) showing worsening multifocal airspace opacities. As seen on axial (C) and coronal (D) images from a contrast-enhanced CT chest performed on HD 84, course was complicated by multiple pneumatoceles (arrows), loculated pneumothoraces (arrowheads), loculated pleural effusions (dashed arrow). Bilateral chest tubes are noted. Barotrauma and infection likely resulted in pneumatoceles with parenchymal-pleural and bronchopleural fistualization and pneumothoraces.