COVID-19 has a variety of presentations and complications, and this study aimed to report the incidence of COVID-19 patients presenting with pneumothorax and bronchopleural fistula (BPF).

Documents of hospitalized COVID-19 patients with positive SARS-COV-2 polymerase chain reaction tests were reviewed respectively, and patients presenting with pneumothorax were included. Laboratory data, treatment, and the outcome were also gathered for each patient.

The incidence of COVID-19 patients presenting with pneumothorax and BPF was 0.93% and 0.62%, respectively. Three cases were determined, and all were male adults. Two had BPF and one received thoracotomy. These 2 patients had significantly elevated inflammatory markers. Patients were treated with antibiotics, corticosteroids, anticoagulants, remdesivir, and tocilizumab. Unfortunately, all expired as 2 patients had a cardiac arrest and one had a multiorgan failure.

Presenting with pneumothorax among COVID-19 patients is not common but needs appropriate management to prevent further complications. It seems that BPF, as a rarely reported complication of COVID-19, might be linked to the inflammatory storm and indicates poor prognosis.