産業医学および健康問題

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Platypnea-Orthodeoxia Syndrome in SARS COVID-19: A Mini Review

Shilpa Madhan

POS is an uncommon condition marked by respiratory distress and/or hypoxia that worsens in the sitting/ standing position but improves in the lying position. Cardiovascular, pulmonary, and non-cardiopulmonary illnesses all contribute to it. COVID-19 can cause a variety of respiratory symptoms, including acute respiratory distress syndrome (ARDS) and pulmonary fibrosis with sequelae. In patients with COVID-19, POS has only been documented on a few occasions. Intra cardiac shunt closure can be curative when Platypnea-Orthodeoxia syndrome is caused by intra cardiac shunting without pulmonary hypertension. Platypnea-Orthodeoxia syndrome is an uncommon illness characterized by dyspnea and de oxygenation brought on by standing and alleviated by lying down. Shunting through a patent foramen oval and pulmonary Arterio venous malformations are two common causes. Shunting should be assessed in both the recumbent and upright postures in individuals with unexplained or transitory hypoxemia who are suspected of having a cardiac etiology. Significant right-to-left shunting does not need increased right atrial pressure in this condition. If possible, percutaneous closure is the initial line of treatment for these patients. Micro thrombi and vasculoplegia along with mainly the basal distribution of the consolidative changes which occurs in severe infection of COVID-19 disease. Platypnea orthodoxies syndrome develops as a result of increased basal physiological shunting and upper zone dead space ventilation due to gravity redistribution of pulmonary blood flow. Platypnea orthodoxies syndrome responds comparatively in a good way to chest physiotherapy and steroids along with oxygen therapy medication. It is understood that POS may mainly affects the posterior and lower zones of lung parenchyma in COVID 19 affected patients.