Introduction
Severe acute respiratory syndrome coronavirus (COVID 19) infection has developed as the greatest pandemic the world with high morbidity and mortality and several complications. There are lots of studies about (COVID-19) and its complications(1-3).There are reports about spontaneous pneumomediastinum (PM), pneumopericardium (PP), pneumothorax (PT), and subcutaneous emphysema (SE) cases in patients with COVID -19, and also some of these complications present in the patients with mechanical ventilation, which results in barotrauma (4). The pathophysiologic mechanism of PM is an increased gradient pressure between the alveoli and parenchyma of lung that leads to severe alveolar injury and the air dissects the surrounding bronchovascular sheaths, and this air enters into the mediastinum and produces PM and disturbance to cervical SE and pleural space PT (2, 4). The pulmonary complications are a sequela of parenchymal, vascular, or pleural involvement and range from pneumonia to acute respiratory distress syndrome (ARDS) and pulmonary embolism to pneumothorax (5). Pneumothorax, defined as air within the pleural space, is one of the emerging complications of COVID-19 infection (6). Alveolar wall is more prone to rupture due to inflammation in COVID-19 patients and alveolar wall is exacerbated by severe cough or any problems which increase the intra-alveolar pressure (4). Invasive positive pressure ventilation can cause PT, SE, PP and PM spontaneously, But spontaneous tension pneumopricardium or spontaneous pneumothorax tension is rare complication in COVID-19 (7). Barotrauma is the cause of PM, PT, PP, and SE (2). In this case report, we focus only on hospitalized COVID-19 patients who developed these complications and diagnosis and treatment.