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Case Reports
. 2022 Jun 7;93(S1):e2022102.
doi: 10.23750/abm.v93iS1.12824.

Platypnea-orthodeoxia syndrome in SARS-CoV-2 related ARDS: a case report

Concetta Aprea  1 , Simona Imbriani  2 , Giovanna Cirigliano  3 , Klodian Gjeloshi  4 , Luciana Agnese Meo  5 , Andrea Padula  6 , Roberta Ranieri  7 , Carmen Ricozzi  8 , Carolina Ruosi  9 , Domenico Cozzolino  10 , Luigi Elio Adinolfi  11 , Riccardo Nevola  12
Affiliations
Case Reports

Platypnea-orthodeoxia syndrome in SARS-CoV-2 related ARDS: a case report

Concetta Aprea et al. Acta Biomed. .

Abstract

Platypnea-Orthodeoxia Syndrome (POS) is an often misdiagnosed clinical condition characterized by dyspnea and hypoxia in sitting or semi-sitting position, reversible in supine position. Although POS is typically associated with intracardiac shunts, it seems frequent also in SARS-CoV-2 related Acute Respiratory Distress Syndrome (ARDS). In fact, the prevalent involvement of the lung bases due to interstitial pneumonia can determine refractory positional hypoxemia, with marked desaturation in the sitting position and regression or improvement in the supine position, configuring the clinical picture of the POS. We present a clinical case of POS associated with acute respiratory distress from SARS-CoV-2 pneumonia in which refractory hypoxia would have required support by invasive mechanical ventilation if the syndrome had not been identified.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
CT scan on admission with details of the apical (A), middle (B) and basal (C) regions and evidence of pulmonary involvement with increasing cranio-caudal gradient.
See this image and copyright information in PMC

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