Department of Medicine, AIIMS, New Delhi, India.
Department of Medicine, AIIMS, New Delhi, India
BMJ Case Rep. 2021 May 5;14(5):e243016. doi: 10.1136/bcr-2021-243016.
Platypnoea-orthodeoxia syndrome (POS) is a rare entity characterised by respiratory distress and/or hypoxia developing in the sitting/upright posture, which is relieved in the supine posture. It is caused by cardiac, pulmonary and non-cardiopulmonary diseases. COVID-19 can have varying respiratory manifestations including acute respiratory distress syndrome (ARDS) and sequelae-like pulmonary fibrosis. POS has been rarely reported in patients with COVID-19. Here we report a case of POS in a patient recovering from severe COVID-19 ARDS. As he was gradually mobilised after his improvement, he had worsening dyspnoea in the sitting position with significant relief on assuming a supine posture. He was diagnosed with POS after ruling out other causes of POS. He was treated with oxygen support in upright posture and chest physiotherapy was continued, to which he showed improvement. POS is a rare manifestation of COVID-19 which needs awareness as it can be diagnosed easily and can respond to continued supportive care.
平卧位低氧血症-直立性呼吸困难综合征（POS）是一种罕见病症，其特征是在坐姿/直立位时出现呼吸窘迫和/或缺氧，而在仰卧位时得到缓解。它由心脏、肺部和非心肺疾病引起。COVID-19 可表现出不同的呼吸系统症状，包括急性呼吸窘迫综合征（ARDS）和类似后遗症的肺纤维化。POS 在 COVID-19 患者中很少见。在这里，我们报告了一例 COVID-19 严重 ARDS 后康复患者的 POS 病例。随着他病情的改善，他逐渐开始活动，但在坐姿时呼吸困难加重，而仰卧位时则明显缓解。在排除其他 POS 病因后，他被诊断为 POS。他在直立位接受氧气支持治疗，并继续进行胸部物理治疗，他的症状有所改善。POS 是 COVID-19 的一种罕见表现，需要引起重视，因为它可以很容易地诊断，并对持续的支持性护理有反应。
