Platypnea-Orthodeoxia Syndrome after SARS-CoV-2 interstitial pneumonia: an overview and an update on our patient

Platypnea-Orthodeoxia Syndrome after SARS-CoV-2 interstitial pneumonia: an overview and an update on our patient

Authors

  • Nicola Zanoni
  • Chiara Longo a:1:{s:5:"en_US";s:26:"University Hospital Parma.";}
  • Annalisa Frizzelli
  • Francesco Longo
  • Rocco Accogli
  • Alfredo Antonio Chetta

Keywords:

Platypnea-Orthodeoxia Syndrome, Platypnea, Orthodeoxia, POS, Pulmonary Fibrosis, SARS-CoV-2

Abstract

Platypnea-Orthodeoxia Syndrome (POS) is a clinical entity defined as positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. Up to April 25th 2021, eleven cases of POS after SARS-CoV-2 pneumonia have been reported on Pubmed. Accordingly, SARS-CoV-2 infection may be considered as an emergent cause of POS due to an increase in ventilation/perfusion (V/Q) mismatch. In this article we provide an update on the patient with POS after fibrotic evolution of SARS-CoV-2 interstitial pneumonia, which we previously reported and we discuss the case reports of POS due to SARS-CoV-2 infection.

References

Agrawal A, Palkar A, Talwar A. The multiple dimensions of Platypnea-Orthodeoxia syndrome: A review. Respir Med. 2017; 129:31–38.

Singh K, Kadnur H, Ray A, Khanna P, Singh A, Wig N, Trikha A. Platypnea-orthodeoxia in a patient with severe COVID-19 pneumonia. Monaldi Arch Chest Dis. 2020 Dec 23;90(4). doi: 10.4081/monaldi.2020.1609. PMID: 33372742.

Tan GP, Ho S, Fan BE, Chotirmall SH, Tan CH, Lew SJW, Chia PY, Young BE, Abisheganaden JA, Puah SH. Reversible platypnea-orthodeoxia in COVID-19 acute respiratory distress syndrome survivors. Respir Physiol Neurobiol. 2020 Nov;282:103515. doi: 10.1016/j.resp.2020.103515. Epub 2020 Aug 7. PMID: 32777268; PMCID: PMC7413098.

Siddique M, Nawaz MK, Khalid MB, Rai A. Right to Left Intrapulmonary Shunt in a Case with COVID-19-associated Pneumonia. J Coll Physicians Surg Pak. 2021 Jan;30(1):S23-S25. doi: 10.29271/jcpsp.2021.01.S23. PMID: 33650419.

Longo C, Ruffini L, Zanoni N, Longo F, Accogli R, Graziani T, Chetta A. Platypnea-orthodeoxia after fibrotic evolution of SARS-CoV-2 interstitial pneumonia. A case report. Acta Biomed. 2020 Aug 10;91(3):ahead of print. doi: 10.23750/abm.v91i3.10386. PMID: 32921749; PMCID: PMC7716968.

George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020 Aug;8(8):807-815. doi: 10.1016/S2213-2600(20)30225-3. Epub 2020 May 15. PMID: 32422178; PMCID: PMC7228727.

Oldani S, Ravaglia C, Bensai S, Bertolovic L, Ghirotti C, Puglisi S, Martinello S, Sultani F, Colinelli C, Piciucchi S, Simoncelli S, Poletti V. Pathophysiology of light phenotype SARS-CoV-2 interstitial pneumonia: from histopathological features to clinical presentations. Pulmonology. 2021 Mar 26:S2531-0437(21)00078-7. doi: 10.1016/j.pulmoe.2021.03.003. Epub ahead of print. PMID: 33832850; PMCID: PMC7997696.

Tham SL, Ong PL, Lee AJY, Tay MRJ. Rehabilitation of Patients with Platypnea-Orthodeoxia Syndrome in COVID-19 Pneumonia: Two Case Reports. J Rehabil Med Clin Commun. 2020;3:1000044. Published 2020 Nov 20. doi:10.2340/20030711-1000044

Elsaaran H, AlQinai S, AlTarrah D, Abdulrasoul M, Al-Youha S, Almazeedi S, Al-Haddad M, Jamal MH, Al-Sabah S. Prevalence and risk factors of barotrauma in Covid-19 patients admitted to an intensive care unit in Kuwait; a retrospective cohort study. Ann Med Surg (Lond). 2021 Mar;63:102141. doi: 10.1016/j.amsu.2021.01.089. Epub 2021 Feb 5. PMID: 33564462; PMCID: PMC7862029.

Chu CM, Leung YY, Hui JY, Hung IF, Chan VL, Leung WS, Law KI, Chan CS, Chan KS, Yuen KY. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur Respir J. 2004 Jun;23(6):802-4. doi: 10.1183/09031936.04.00096404. PMID: 15218989.

Gattinoni, L., Chiumello, D. & Rossi, S. COVID-19 pneumonia: ARDS or not?. Crit Care 24, 154 (2020). https://doi.org/10.1186/s13054-020-02880-z.

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Published

14-03-2022

Issue

Section

ORIGINAL INVESTIGATIONS/COMMENTARIES - SPECIAL COVID19

How to Cite

1.
Zanoni N, Longo C, Frizzelli A, Longo F, Accogli R, Chetta AA. Platypnea-Orthodeoxia Syndrome after SARS-CoV-2 interstitial pneumonia: an overview and an update on our patient. Acta Biomed [Internet]. 2022 Mar. 14 [cited 2024 Jul. 18];93(1):e2022015. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/11814