Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 9 4 2025 02 22 164 168 Behgam Fatehi Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Morteza Talebi Doluee Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Elnaz Vafadar Moradi Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2024 11 15 2024 11 17 Spontaneous pneumorrhachis and pneumoperitoneum are very rare conditions that involve the presence of air within the spinal canal and peritoneum, respectively, without any traumatic or underlying disease.During the COVID-19 pandemic,there have been reports of spontaneous pneumomediastinum occurring in some patients with severe cases of the virus. Herein, we present a case of spontaneous pneumomediastinum, pneumothorax, pneumoperitoneum, pneumoretroperitoneum, pneumorrhachis, and subcutaneous emphysema in a young male without any past medical history of pulmonar y dise ase and PCR positive for COVID-19. He complained of mild dyspnea with sudden non-painful facial edema. One possible explanation for SPM in COVID-19 patients is the severe inflammation and damage to lung tissue caused by the virus. Also, now that the pandemic is over and the disease is not as severe as it was at the beginning, unknown aspects of the complications of this disease will appear. These complications are typically self-limiting and follow a benign clinical course. https://crcp.tums.ac.ir/index.php/crcp/article/view/1000 https://crcp.tums.ac.ir/index.php/crcp/article/download/1000/677