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COVID19 and Tension Pneumothorax— Life threatening complication of COVID -19 patients on Non-invasive ventilation or mechanical ventilation: Often missed but must not be missed

Mayank Vats

Pneumothorax could be an inevitable and could be life threatening complication of COVID patients as they may have following aetiologies:

 Some undiagnosed blebs or bullae due to chronic smoking status or due to COPD  Area of necrosis due to the intrinsic disease processes and could be small necrotic infarcts in lung which my rupture when patient are kept on high PEEP or high Inspiratory pressure support by ventilator especially high PEEP,

hence in any patient who is suddenly deteriorating, and on ventilator we should have strong suspicion of pneumothorax and a proper sitting CXR should be done because sometimes the mild pneumothorax may be missed in the supine CXR which are usually carried out in ICU,

 Hence this case report emphasizes the importance of sitting CXR in suddenly deteriorating patient apart from stating the possible life-threatening tension pneumothorax as a complication of COVID patients secondary to high PEEP during ventilation.