• Mansoor Hameed, Wasim Jamal, Muhammad Yousaf, Merlin Thomas, Irfan Ul Haq, Shakeel Ahmed, Mushtaq Ahmad, and Mohamad Khatib.
• Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
• Respir Med Case Rep. 2020 Jan 1; 31: 101265.

BackgroundCoronavirus disease 2019 (Covid-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It mainly affects the lungs and common symptoms are fever, cough and shortness of breath. Pneumothorax has been noted to complicate Covid-19 cases requiring hospital admission, however the exact incidence and risk factors are still unknown.DiscussionWe present a series of 3 cases of primary spontaneous pneumothorax with Covid-19 pneumonia. All cases in our series did not require positive pressure ventilation and none had any pre-existing lung disease. All were never smokers and had favourable outcomes despite having severe Covid-19 with a pneumothorax during the course of the disease. In our literature review we discuss several plausible mechanisms and risk factors resulting in a pneumothorax with Covid-19.ConclusionOur cases are a reminder that an acute deterioration with hypoxia in a Covid-19 patient could indicate a pneumothorax. Pneumothorax is one of the reported complications in Covid-19 and clinician vigilance is required during assessment of patients, as both share the common symptom of breathlessness and therefore can mimic each other.© 2020 The Author(s).

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