Platypnea-Orthodeoxia Syndrome Associated with COVID-19 Pneumonia and Prolonged Treatment Due to Tamsulosin Use: A Case Report

Year 2023, , 7 - 9, 07.04.2023

Muhammet Kızmaz , Ayşe Turunç Özdemir Zeynep Alkan

https://doi.org/10.33706/jemcr.1177998

Cited By: 1

Abstract

Platypnea-orthodeoxia syndrome (POS) is an extremely rare condition. There are no other cases in the literature where tamsulosin has been reported to prolong POS treatment. A 67-year-old male patient was hospitalized due to COVID-19. He was followed up in the ward after being in the intensive care unit for ten days. There was a significant decrease in saturation (SaO2) when sitting and standing compared to lying. He was diagnosed with POS. However, there was no significant improvement in POS with exercises. After stopping the tamsulosin he was using, there was a dramatic improvement. He was discharged on the 72nd day of his hospitalization. Due to COVID-19, POS is more likely to appear than before. It is a condition that clinicians should recognize. The pathophysiology of POS has not been fully elucidated. The case we present suggests that alpha-blockers may also be related to pathophysiology.

Keywords

COVID-19, Platypnoea-orthodeoxia syndrome, SARS-CoV-2

References

• 1-Agrawal A, Palkar A, Talwar A. The multiple dimensions of Platypnea-Orthodeoxia syndrome: A review. Respir Med. 2017; 129:31–38.
• 2-Burchell HBHHJ, Wood EH. Reflex orthostatic dyspnea associated with pulmonary hypotension. Am. J. Physiol. 1949; 159:563–564.
• 3-Altman M, Robin ED. Platypnea (diffuse zone I phenomenon?) N. Engl. J. Med. 1969; 281:1347–1348.
• 4-Robin ED, Laman D, Horn BR, Theodore J. Platypnea related to orthodeoxia caused by true vascular lung shunts. N. Engl. J. Med. 1976; 294:941–943.
• 5-Tan GP, Ho S, Fan BE, et al. 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.
• 6-Longo C, Ruffini L, Zanoni N, et al. Platypnea-orthodeoxia after fibrotic evolution of SARS-CoV-2 interstitial pneumonia. A case report. Acta Biomed. 2020 Aug;91(3):e2020052. doi:10.23750/abm.v91i3.10386.
• 7-Singh K, Kadnur H, Ray A, et al. Platypnea-orthodeoxia in a patient with severe COVID-19 pneumonia. Monaldi Arch Chest Dis. 2020 Dec;90(4). doi: 10.4081/monaldi.2020.1609.
• 8-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 Nov;3:1000044. doi:10.2340/20030711-1000044.
• 9- Aayilliath K A, Singh K, Ray A, Wig N. Platypnoea-orthodeoxia syndrome in COVID-19. BMJ Case Rep. 2021 May;14(5):e243016. doi:10.1136/bcr-2021-243016.
• 10- Agrawal A, Palkar A, Talwar A. The multiple dimensions of platypnea-orthodeoxia syndrome: a review. Respir Med. 2017;129:31–8.