SARS-CoV-2 with concurrent coccidioidomycosis complicated by refractory pneumothorax in a Hispanic male: A case report and literature review

Table 1 Literature review on reported pneumothorax cases in severe acute respiratory syndrome coronavirus 2 among non-ventilated patients

Ref.	Gender/Age	Presence of cough	Smoking history	Underlying lung disease	Presence of blebs/bullae on CT	Other CT findings	Intervention provided for PT	Management provided	Outcome
Sun et al[13]	38/M	+	None	None	Yes (bullae)	GGO, consolidation, giant bulla	Unknown	Symptomatic careHFNC	Unknown
López Vega et al[16], Case 1	84/F	+	None	None	CXR- none	Hydropneumothorax, pneumomediastinum	Unknown	HCQ, ceftriaxone, methylpredisone	Died
López Vega et al[16], Case 2	67/M	No	None	None	None	PT, GGO, thickening of septa	Pleural drainage tube	Zosyn, AZM	Died
López Vega et al[16], Case 3	73/M	No	None	OSA	None	Pneumomediastinum + PTE	AG +CPAP	HCQ, AZM, tocilizumab, methyl prednisone	Died
Spiro et al[11]	47/M	+	None	None	None	GGO + consolidations +tension PT	Chest drain (Buelau) + open thoracotomy	AZM	Survived
Wang et al[3]	36/F	+	None	None	None	GGO + interlobular septal thickening with pl effusion and bronchiectasis	Supportive care	Combined anti-viral and anti-inflammatory	Died
Flower et al[9]	36/M	+	+ 10 Pack yr	Asthma	Yes(bullae)	Initial CXR- tension pneumothorax; CT-Patchy consolidation + bullae	Emergency needle decompression with chest tube placement	Unknown	Survived
Wang et al[23]	62/M	+	None	None	None	GGO + consolidations + PT + pneumomediastinum + SC emphysema	Spontaneous resolution	Lopinavir/ritonavir, antibiotics, methylprednsiolone	Survived
Ucpinar et al[24]	82/F	+	None	None	No	GGO + pneumomediastinum + PT+ SC emphysema	Chest tube	HCQ, oseltamivir, ceftriaxone	Survived
Rohailla et al[25]	26/M	None	None	None	None	CXR-PT	Chest drain	Supportive care	Survived
Zantah et al[14], Patient 1	49/M	+	None	None	None	GGO + consolidations	Chest tube	Abs, CS, CP + Tocilizumab	Died
Zantah et al[14], Patient 3	81/F	No	Unknown	None	None	GGO + consolidative changes + consolidation in RUL	Chest tube	Abs, CS + Remdesivir	Died
Hazariwala et al[8]	67/M	+	Unknown	None	None	GGO + SC emphysema + PT	Conservative measures	Ab, antiviral, methylprednisolone	Survived
Kolani et al[26]	23/F	No	Unknown	None	None	GGO + pneumomediastinum	Spontaneous resolution	AZM, HCQ	Survived
Zhou et al[27]	38/M	+	Unknown	None	None	GGO + consolidations + pneumomediastinum + SC emphysema	Spontaneous resolution	Abs, antiviral, CS	Survived
Mohan et al[28]	49/M	+	None	None	None	Pneumomediastinum + SC emphysema	Spontaneous resolution	Abs, HCQ, CS, AG	Survived
Corrêa Neto et al[29]	80/F	+	No	No	No	CT- GGO + PT. pneumomediastinum	Chest drain	Abs, antiviral	Died
Hollingshead et al[30]	50/M	No	Unknown	Unknown	None	CTA- GGO + loculated PT	Chest tube	Unknown	Survived
Lei et al[31]	64/M	No	Unknown	Unknown	None	CT- resolution of pneumonic lesions + spontaneous pneumomediastinum	Unknown	Unknown	Unknown
Ahluwali et al[32]	31/M	+	No	None	None	CXR- tension PTCT- pneumomediastinum + pneumopericardium + PT + consolidations + multilobar PNA	Chest tube	HCQ + tocilizumab	Survived
Sahu et al[17]	61/M	No	No	None	None	CXR- pneumomediastinum + pneumopericardium	Supportive care	Remdesivir + CP + tocilizumab	Died
Hazariwala et al[8], Patient 1	57/F	+	Unknown	Asthma	None	CT pneumomediastinum+ PT + SC emphysema	Chest tube	HCQ +zinc+ AZM+ CS	Died
Hazariwala et al[8], Patient 2	55/M	+	+ 50 pack year	Asthma	None	CT- pneumomediastinum+ + SC emphysema + pneumoperitoneum	Supportive care	HCQ +zinc+ AZM+ CS	Died
Al-Shokri et al[33], Patient 1	55/M	+	No	None	None	CT-pneumomediastinum + PT	Chest tube	HCQ + AZM	Survived
Al-Shokri et al[33], Patient 3	50/M	+	Unknown	Unknown	No	CT- PT + mediastinal shift	Thoracostomy + Chest tube	HCQ + AZM	Survived
Chen et al[34]	66/M	+	Unknown	None	No	CT- GGO + PT	Thoracic closed drain	Anti-viral + Abs + Immunoglobulins + methylprednisolone	Survived

IMV: Invasive mechanical ventilation; PT: Pneumothorax; GGO: Ground glass opacities; HFNC: High flow nasal cannula; AG: Anticoagulation; HCQ: Hydroxychloroquine; AZM: Azithromycin; CP: Convalescent plasma.

Table 2 Literature review on reported pneumothorax cases in severe acute respiratory syndrome coronavirus 2 among ventilated patients

Ref.	Gender/Age	Presence of cough	Smoking history	Underlying lung disease	Presence of blebs/bullae on CT	Other CT findings	Intervention provided for PT	Management provided	Outcome
Xiang et al[35]	67/M	No	Unknown	Chronic bronchitis, emphysema and obsolete pulmonary TB	Unknown (no CT)	No CT- CXR showing SC emphysema	Chest close drainage	Anti-viral, anti-bacterial therapy, vasoconstrictors	Died
Zantah et al[14], Patient 2	59/M	+	Unknown	None	None	GGO + consolidations + crazy paving pattern	Chest tube	Abs, CS, CP + Tocilizumab	Survived
Zantah et al[14], Patient 4	45/F	+	Unknown	None	None	GGO + consolidative changes	Chest tube	Abs, CS, CP + Tocilizumab	Survived
Zantah et al[14], Patient 5	47/F	+	Unknown	None	None	GGO + consolidations	Chest tube	Abs, CS, AG, Tocilizumab	Died
Zantah et al[14], Patient 6	76/F	No	Unknown	Pulmonary sarcoidosis	None	Consolidations	Chest tube	Unknown	Died
Al-Azzawi et al[36], Patient 1	36/M	+	Unknown	None	None	GGO + pneumomediastinum + SC emphysema	Improved without intervention	AZM, Vit C, zinc, HCQ, Tocilizumab, CS, ECMO	Died
Al-Azzawi et al[36], Patient 2	47/M	No	Unknown	None	None	CXR- SC emphysema + pneumomediastinum	Chest tube	HCQ, zinc, AZM, tocilizumab,	Survived
Al-Azzawi et al[36], Patient 3	78/M	No	Unknown	None	None	CXR- SC emphysema + pneumomediastinum	None	AZM, Vit C, zinc, HCQ	Died
Aiolfi et al[37], Patient 1	56/M	+	Active smoker	Unknown	Superficial bleb +	CXR – pneumothorax; CT – GGO	Pleural darin, 3 port thoracoscopy, bleb resection, mechanical pleurodesis	Unknown	Survived
Aiolfi et al[37], Patient 2	70/M	No	No	No	Superficial bleb +	CT- GGO	Chest tube, 3 port thoracoscopy, bleb resection	Unknown	Survived
Al-Shokri et al[33], Patient 2	33/M	+	Unknown	Unknown	Yes (bulla)	CT- tension PT + bulla and mild pneumomediastinum	Chest tube	HCQ + AZM	Survived
Abushahin et al[38]	47/M	+	Unknown	None	No	CT- spontaneous PT	Pigtail chest tube	Abs + HCQ +	Survived

IMV: Invasive mechanical ventilation; PT: Pneumothorax; GGO: Ground glass opacities; HFNC: High flow nasal cannula; AG: Anticoagulation; HCQ: Hydroxychloroquine; AZM: Azithromycin; CP: Convalescent plasma.