https://doi.org/10.4081/monaldi.2022.2406
Persistent unilateral diaphragmatic paralysis in the course of Coronavirus Disease 2019 pneumonia: a case report
Submitted: August 13, 2022
Accepted: November 16, 2022
Published: November 23, 2022
Accepted: November 16, 2022
Abstract Views: 959
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Coronavirus Disease 2019 infections can cause a wide range of symptoms, particularly in the respiratory system. Diaphragmatic paralysis is a rare condition that is poorly documented in the literature. We present the case of a 38-year-old Caucasian male adult who developed unilateral diaphragmatic paralysis during the course of the disease. The patient presented to the Emergency Department with fever, cough, and dyspnea, was admitted, and was immediately fitted with a high flow nasal cannula. When his condition worsened eight days later, he was admitted to the Intensive Care Unit and a tracheostomy was performed. A CT scan of the chest revealed significant left diaphragm elevation. On the 48th day, the patient gradually improved and was discharged. The paralysis of the diaphragm persisted three months later in the follow-up examination. This case illustrates a possible neuromuscular virus invasion that may have an impact on the patient's health after discharge.
Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-COV-2 and COVID-19. Nat Rev Microbiol 2021;19:141-54.
DOI: https://doi.org/10.1038/s41579-020-00459-7
Mokhtari T, Hassani F, Ghaffari N, et al. COVID-19 and multiorgan failure: a narrative review on potential mechanisms. J Mol Histol 2020;51:613-28.
DOI: https://doi.org/10.1007/s10735-020-09915-3
Ricoy J, Rodríguez-Núñez N, Álvarez-Dobaño JM, et al. Diaphragmatic dysfunction. Pulmonology 2019;25:223-35.
DOI: https://doi.org/10.1016/j.pulmoe.2018.10.008
Patel Z, Franz CK, Bharat A, et al. Diaphragm and phrenic nerve ultrasound in COVID-19 patients and beyond imaging technique, findings, and clinical applications. J Ultrasound Med 2022;41:285-99.
DOI: https://doi.org/10.1002/jum.15706
World Health Organization. WHO Coronavirus (COVID-19) Dashboard. Accessed: 2022 July 29. Available from https://COVID-19.who.int
Beghi E, Giussani G, Westenberg E, et al. Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions. J Neurol 2022;269:2265-74.
DOI: https://doi.org/10.1007/s00415-021-10848-4
Supinski GS, Morris PE, Dhar S, Callahan LA. Diaphragm dysfunction in critical illness. Chest 2018;153:1040-51.
DOI: https://doi.org/10.1016/j.chest.2017.08.1157
Abdeldayem EH, Abdelrahman AS, Mansour MG. Recognition of phrenic paralysis as atypical presentation during CT chest examination of COVID-19 infection and its correlation with CT severity scoring: a local experience during pandemic era. Egypt J Radiol Nucl Med 2021;52:156.
DOI: https://doi.org/10.1186/s43055-021-00527-9
Dandawate N, Humphreys C, Gordan P, Okin D. Diaphragmatic paralysis in COVID-19: a rare cause of postacute sequelae of COVID-19 dyspnoea case report. BMJ Case Rep 2021;14:e246668.
DOI: https://doi.org/10.1136/bcr-2021-246668
Fitzmaurice TS, Mccann C, Walshaw M, et al. Unilateral diaphragm paralysis with COVID-19 infection case report. BMJ Case Rep 2021;14:e243115.
DOI: https://doi.org/10.1136/bcr-2021-243115
Maurier F, Godbert B, Perrin J. Respiratory distress in SARS-CoV-2 without lung damage: phrenic paralysis should be considered in COVID-19 infection. Eur J Case Rep Intern Med 2020;7:001728.
Shahid M, Nasir SA, Shahid O, et al. Unilateral diaphragmatic paralysis in a patient with COVID-19 pneumonia. Cureus 2021;13:e19322.
DOI: https://doi.org/10.7759/cureus.19322
Farr E, Wolfe AR, Deshmukh S, et al. Diaphragm dysfunction in severe COVID-19 as determined by neuromuscular ultrasound. Ann Clin Transl Neurol 2021;8:1745-9.
DOI: https://doi.org/10.1002/acn3.51416
Selden TM, Berdahl TA. Diaphragm pathology in critically ill patients with COVID-19 and postmortem findings from 3 medical centers. JAMA Intern Med 2021;181:122-4.
DOI: https://doi.org/10.1001/jamainternmed.2020.6278
Pitarokoili K, Kramer CL, Katyal N, et al. Neuromuscular complications with SARS-COV-2 infection: a review. Front Neurol 2020;11:1052.
DOI: https://doi.org/10.3389/fneur.2020.01052
How to Cite
Skouvaklidou, Elpida, Ioannis Neofytou, Maria Kipourou, and Konstantinos Katsoulis. 2022. “Persistent Unilateral Diaphragmatic Paralysis in the Course of Coronavirus Disease 2019 Pneumonia: A Case Report”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2022.2406.
Copyright (c) 2022 The Author(s)
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