The first reported use of autologous blood pleurodesis for treatment of prolonged air leak in COVID‐19‐related spontaneous pneumomediastinum and pneumothorax: A case report

S. Rashid Ali, Muhammad Redzwan

Spontaneous pneumomediastinum (SPM) and pneumothorax (PTX) have been described as rare complications of COVID‐19 pneumonia. We present a case of COVID‐19 pneumonia which was complicated by SPM on Day 13 of admission with progression to spontaneous PTX 2 days later which necessitated intercostal chest drainage. It was complicated by prolonged air leak (PAL) for the next 9 days despite being on continued low‐dose suction and another additional larger bore intercostal drain inserted. Surgical pleurodesis was not an option in view of anaesthesia and operative risk expected in COVID‐19. In view of this, autologous blood pleurodesis (ABP) to address the alveolar pleural leak was opted. ABP has been previously used for PAL in cases of non‐COVID‐19‐related intractable spontaneous PTX. The air leak ceased with subsequent lung re‐expansion, with good clinical and radiological improvement. He was discharged well after resolution of PTX which required intercostal drain for a total of 15 days.