Bilateral diaphragmatic dysfunction: A cause of persistent dyspnea in patients with post-acute sequelae of SARS-CoV-2
SAGE Open Medical Case Reports
; 10, 2022.
Article
in English
| EMBASE | ID: covidwho-1916523
ABSTRACT
Persistent shortness of breath is one of the most common concerns reported by patients with post-acute sequelae of SARS-CoV-2. Here, we present a case of bilateral diaphragmatic paralysis as a cause shortness of breath that developed after SARS-CoV-2 infection. A middle-aged gentleman with history of sleep apnea and body mass index 27.9 kg/m2 presented to our post-COVID clinic with 3 months of dyspnea and orthopnea after contracting SARS-CoV-2 in November 2020. During acute infection, he was hospitalized for hypoxemia, which improved with steroids and supplemental oxygen. At 3 months, he continued to report dyspnea and orthopnea. On examination, he had tachycardia and increased respiratory rate with paradoxical respiratory abdominal movement. Chest imaging showed elevated bilateral hemidiaphragms without any parenchymal lung disease. Pulmonary function test revealed severe ventilatory defect with restrictive lung disease. He was diagnosed with bilateral diaphragmatic dysfunction which was confirmed by absence of evoked potentials in diaphragm after phrenic nerve stimulation bilaterally. He was advised to use continuous positive airway pressure machine to assist with breathing at night. At his last follow-up (1-year post-infection), he was symptomatically improving without specific interventions.
adult; article; body mass; breathing; breathing rate; case report; clinical article; complication; continuous positive airway pressure; coronavirus disease 2019; diaphragm paralysis; dyspnea; evoked response; follow up; hemidiaphragm; human; hypoxemia; injury; long COVID; lung disease; lung function test; male; middle aged; nerve stimulation; neurologic disease; night; nonhuman; phrenic nerve; Severe acute respiratory syndrome coronavirus 2; sleep disordered breathing; tachycardia; oxygen; steroid
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Long Covid
Language:
English
Journal:
SAGE Open Medical Case Reports
Year:
2022
Document Type:
Article
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