1 INTRODUCTION
The outbreak of coronavirus disease 2019 (COVID-19) infection has been widespread all over the world. COVID-19 infection can cause various complications and pneumothorax secondary to COVID-19 is relatively rare. Pneumothorax as a complication of COVID-19 infection occurs in 1% of hospitalized COVID-19 patients1 and 2% of COVID-19 patients in intensive care unit2. Simultaneous bilateral spontaneous pneumothorax is an extremely rare condition that is found in only 1% of all patients with spontaneous pneumothorax3. There have been few reports of bilateral pneumothorax due to COVID-19. There is no treatment strategy for secondary spontaneous pneumothorax due to COVID-19. In patients with poor general condition and who are not fit for surgery, refractory pneumothorax must be cured by internal therapies (chest drainage, bronchial occlusion and pleurodesis, and so on). There are various drugs in pleurodesis and autologous blood is a better adhesion in terms of efficacy and side effects. We herein report a rare case of a severe COVID-19 patient with bilateral refractory pneumothorax treated by combining internal treatments.