{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:06:32Z","timestamp":1755907592810,"version":"3.44.0"},"reference-count":8,"publisher":"SMC Media","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Platypnoea-orthodeoxia syndrome (POS) is a condition characterized by dyspnoea and hypoxaemia while sitting or standing, which improves during decubitus. It is usually caused by intracardiac right-to-left shunting through a patent foramen ovale but may also occur due to pulmonary ventilation-perfusion mismatch of other aetiologies. A new cause of POS was recently described: SARS-CoV-2 pneumonia. We report the case of a 62-year-old man admitted for SARS-CoV-2 pneumonia with respiratory failure. Chest computed tomography angiography showed pulmonary thromboembolism and parenchymal lung changes compatible with COVID-19. He had worsening dyspnoea in a sitting position, relieved by assuming the dorsal position. He was diagnosed with POS after other causes were excluded. POS is an underdiagnosed complication of COVID-19 and is manageable with respiratory rehabilitation.<\/jats:p>","DOI":"10.12890\/2022_003385","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T03:06:21Z","timestamp":1660878381000},"source":"Crossref","is-referenced-by-count":1,"title":["Severe Pneumonia Caused by SARS-CoV-2: A Novel Cause of Platypnoea-Orthodeoxia Syndrome"],"prefix":"10.12890","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3616-9417","authenticated-orcid":false,"given":"Jos\u00e9 Pedro","family":"Abreu Fernandes","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, Centro Hospitalar e Universit\u00e1rio de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Santos Faria","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina F\u00edsica e Reabilita\u00e7\u00e3o, Centro Hospitalar e Universit\u00e1rio de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreia","family":"Fernandes","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Endocrinologia, Instituto Portugu\u00eas de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Rita","family":"Ramalho","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, Centro Hospitalar e Universit\u00e1rio de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Gir\u00e3o","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, Centro Hospitalar e Universit\u00e1rio de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Petrova","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, Centro Hospitalar e Universit\u00e1rio de Coimbra EPE, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"10.12890\/2022_003385_ref1","doi-asserted-by":"crossref","unstructured":"<li>Agrawal A, Palkar A, Talwar A. The multiple dimensions of platypnea-orthodeoxia syndrome: a review. <em>Respir Med<\/em> 2017;<strong>129<\/strong>:31\u201338. doi: 10.1016\/j.rmed.2017.05.016.<\/li>","DOI":"10.1016\/j.rmed.2017.05.016"},{"key":"10.12890\/2022_003385_ref2","doi-asserted-by":"crossref","unstructured":"<li>De Vecchis R, Baldi C, Ariano C, Giasi A, Cioppa C. Platypnea-orthodeoxia syndrome: orthostatic dyspnea and possible pathophysiological substrates. <em>Herz<\/em> 2017;<strong>42<\/strong>(4):384\u2013389. doi: 10.1007\/s00059-016-4479-4. <\/li>","DOI":"10.1007\/s00059-016-4479-4"},{"key":"10.12890\/2022_003385_ref3","doi-asserted-by":"crossref","unstructured":"<li>De Vecchis R, Baldi C, Ariano C. Platypnea-orthodeoxia syndrome: multiple pathophysiological interpretations of a clinical picture primarily consisting of orthostatic dyspnea. <em>J Clin Med<\/em> 2016;<strong>5<\/strong>(10):85. doi: 10.3390\/jcm5100085. <\/li>","DOI":"10.3390\/jcm5100085"},{"key":"10.12890\/2022_003385_ref4","doi-asserted-by":"crossref","unstructured":"<li>Tan GP, Ho S, Fan BE, Chotirmall SH, Tan CH, Lew SJW, et al. Reversible platypnea-orthodeoxia in COVID-19 acute respiratory distress syndrome survivors.<em>Respir Physiol Neurobiol<\/em> 2020;<strong>282<\/strong>:103515. doi: 10.1016\/j.resp.2020.103515. <\/li>","DOI":"10.1016\/j.resp.2020.103515"},{"key":"10.12890\/2022_003385_ref5","unstructured":"<li>Longo C, Ruffini L, Zanoni N, Longo F, Accogli R, Graziani T, et al. Platypnea-orthodeoxia after fibrotic evolution of SARS-CoV-2 interstitial pneumonia. A case report. <em>Acta Biomed<\/em> 2020; <strong>91<\/strong>(3):ahead of print. doi: 10.23750\/abm.v91i3.10386. <\/li>"},{"key":"10.12890\/2022_003385_ref6","doi-asserted-by":"crossref","unstructured":"<li>Souza T, Dantas F, Loureiro C, Serra J, Marinho J. Ampliando o diagn\u00f3stico diferencial: infec\u00e7\u00e3o pelo SARS-CoV-2 associada a pneumomediastino e s\u00edndrome platipneia-ortodeoxia. <em>Revista Cient\u00edfica Hospital Santa Izabel<\/em> 2021;<strong>4<\/strong>:159\u2013163. doi: 10.35753\/rchsi.v4i3-4.185.<\/li>","DOI":"10.35753\/rchsi.v4i3-4.185"},{"key":"10.12890\/2022_003385_ref7","doi-asserted-by":"crossref","unstructured":"<li>Tham SL, Ong PL, Lee AJY, Tay MRJ. Rehabilitation of patients with platypnea-orthodeoxia syndrome in COVID-19 pneumonia: two case reports. <em>J Rehabil Med Clin Commun<\/em> 2020;<strong>3<\/strong>:1000044. doi: 10.2340\/20030711-1000044. <\/li>","DOI":"10.2340\/20030711-1000044"},{"key":"10.12890\/2022_003385_ref8","doi-asserted-by":"crossref","unstructured":"<li>Tedjasaputra V, S\u00e1 RC, Anderson KM, Prisk GK, Hopkins SR. Heavy upright exercise increases ventilation-perfusion mismatch in the basal lung: indirect evidence for interstitial pulmonary edema. <em>J Appl Physiol<\/em> (1985) 2019;<strong>127<\/strong>(2):473\u2013481. doi: 10.1152\/japplphysiol.00056.2019.<\/li>","DOI":"10.1152\/japplphysiol.00056.2019"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3385\/3190","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3385\/3191","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3385\/3191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T09:24:03Z","timestamp":1755854643000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/3385"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,19]]},"references-count":8,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.12890\/2022_003385","relation":{"has-manifestation":[{"id-type":"other","id":"1-89-3385-g3190","asserted-by":"subject"},{"id-type":"other","id":"1-89-3385-g3191","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-89","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2022,8,19]]}}}