A rare case of Platypnoea-Orthodeoxia syndrome in COVID-19: BMJ report
Clinical manifestations of COVID-19 which is caused by SARS-CoV2 range from mild upper respiratory symptoms to life-threatening severe acute respiratory distress syndrome (ARDS) requiring invasive mechanical ventilatory support. Dr.Adarsh et al from AIIMS, New Delhi reported a rare case of platypnoea-orthodeoxia syndrome (POS) in a patient recovering from COVID-19 ARDS.
A 46-year old patient presented with history of fever of 7 days and dyspnea of 3 days duration. He had severe breathlessness both in lying down as well as supine position and had grade 4 dyspnoea. His past history was notable for diffuse large B-cell lymphoma for which he received chemotherapy and autologous stem cell transplantation 5 years ago.
Upon examination, patient had tachycardia, tachypnea, hypoxemia with oxygen saturation of 90%-94% on non-rebreathing mask at 10L/min of oxygen. Respiratory system examination revealed normal vesicular breath sounds with bilateral diffuse crepitations. Examination of other systems including CVS was within normal limits.
His blood investigations showed anemia, thrombocytopenia and raised inflammatory markers including CRP, Ferritin, Il-6 and LDH. Throat swab and nasopharyngeal swab for SARS-Cov2 RTPCR was positive. HRCT revealed bilateral diffuse ground-glass opacities throughout lung fields. ECG and ECHO done to rule out pulmonary embolism were normal.
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