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

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


  • 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"";}


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


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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How to Cite

Aprea C, Imbriani S, Cirigliano G, Gjeloshi K, Meo LA, Padula A, et al. Platypnea-orthodeoxia syndrome in SARS-CoV-2 related ARDS: a case report. Acta Biomed [Internet]. 2022 Jun. 7 [cited 2024 Jul. 13];93(S1):e2022102. Available from: