Unusual paraseptal emphysema as the primary changes in computerized tomography scan of a COVID-19 patient. Case report

Covid-19 pandemic has infected more than 20 million people worldwide and claimed more than 750,000 lives so far. Given that this disease is new, the long-term lung effects for survivors especially of severe cases are unknown. Most radiographic changes compared to those commonly seen in Acute Respiratory Distress Syndrome (ARDS), manifested as groundglass opacities or diffuse interstitial/alveolar changes. We present a case of severe acute respiratory failure secondary to COVID-19 requiring prolonged mechanical ventilation and hospitalization with subsequent lung damage and unusual formation of extensive paraseptal emphysematous changes which predominantly affect the lungs apices with subsequent spontaneous pneumothorax. Currently, the long-term impacts on survivors of severe COVID-19 infections are unknown. Future long-term follow-up studies will likely confirm a significant burden and many long-lasting disabilities to the society. Keywords: COVID-19, VILI, Paraseptal Emphysema, Pulmonary fibrosis, Pneumothorax