High incidence and mortality of pneumothorax in critically Ill patients with COVID-19

•Pneumothorax may be a frequent and fatal complication in critically ill patients with COVID-19.•Pneumothorax was likely to occur 2 weeks after the beginning of dyspnea in senile male patients.•Mechanical ventilation, recruitment maneuver, forced inhalation, severely coughing, and changes of lung structure and function, contribute to the occurrence of pneumothorax. Lung recruitment maneuver should be cautiously considered.