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

Concetta Aprea; Simona Imbriani; Giovanna Cirigliano; Klodian Gjeloshi; Luciana Agnese Meo; Andrea Padula; Roberta Ranieri; Carmen Ricozzi; Carolina Ruosi; Domenico Cozzolino; Luigi Elio Adinolfi; Riccardo Nevola

doi:10.23750/abm.v93iS1.12824

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

Authors

Concetta Aprea University of Campania “Luigi Vanvitelli”
Simona Imbriani University of Campania “Luigi Vanvitelli”
Giovanna Cirigliano University of Campania “Luigi Vanvitelli”
Klodian Gjeloshi University of Campania “Luigi Vanvitelli”
Luciana Agnese Meo University of Campania “Luigi Vanvitelli”
Andrea Padula University of Campania “Luigi Vanvitelli”
Roberta Ranieri University of Campania “Luigi Vanvitelli”
Carmen Ricozzi University of Campania “Luigi Vanvitelli”
Carolina Ruosi University of Campania “Luigi Vanvitelli”
Domenico Cozzolino University of Campania “Luigi Vanvitelli”
Luigi Elio Adinolfi University of Campania “Luigi Vanvitelli”
Riccardo Nevola a:1:{s:5:"en_US";s:41:"University of Campania "Luigi Vanvitelli"";}

Keywords:

COVID-19, SARS-CoV-2, Platypnea-Orthodeoxia Syndrome, ARDS

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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