recurrent pneumothorax and pneumomediastinum as a complication of covid-19 in a young athlete

A novel coronavirus, sars-cov-2 was identified as the cause of a cluster of pneumonia cases in wuhan, china in december 2019. coronavirus disease 2019 (covid-19) has rapidly spread worldwide. numerous studies have shown diverse findings on chest ct scan of the patients with covid-19. the established well-known features of covid-19 on chest imaging include bilateral multilobar ground-glass opacification (ggo) predominantly with peripheral distribution, mainly in the lower lobes. atypical presentation of consolidative opacities superimposed on ggo may be found in a smaller number of cases, mainly in the elderly populations. pleural and pericardial effusion, lymphadenopathy, cavitation, halo sign on ct scan, and pneumothorax are uncommon but may be seen with disease progression. we report a case of severe covid-19 in an athlete man with development of bilateral pneumothorax, pneumomediastinum and subcutaneous emphysema during progression of the disease. the only risk factor for severe covid-19 in our patient was suggested to be chronic use of dexamethasone as anabolic steroids. our patient also received three sessions of plasmapheresis. unfortunately, the patient expired due to recurrence of bilateral pneumothorax and pneumomediastinum.