Favourable outcome after a delayed complication secondary to COVID-19

A 41-year-old man was admitted to hospital with 7-day history of fever, cough and having had a positive SARS-CoV-2 PCR test. The chest radiograph (CXR) showed bilateral peripheral parenchymal infiltrates. He required 4 L/min oxygen via nasal cannula for 72 hours and was discharged after 7 days with appropriate advice. Four weeks from initial hospital admission, he presented with worsening cough, left chest pain and breathlessness. CXR showed left pneumothorax, and CT pulmonary angiogram (CTPA) scan confirmed left pneumothorax with mediastinal shift and a subpleural bulla. Intercostal chest drain was inserted with good resolution of symptoms and lung re-expansion. Follow-up CT scan 2 months later showed complete resolution of the parenchymal abnormalities. Our case demonstrates the development of pneumothorax as a delayed complication in a patient with COVID-19 who did not require ventilatory support. The case also illustrates a favourable outcome, that is, complete resolution of parenchymal destruction due to COVID-19.