Respiratory Distress in SARS-CoV-2 without Lung Damage: Phrenic Paralysis Should Be Considered in COVID-19 Infection

  • Francois Maurier Hôpitaux Privés de Metz, Metz, France http://orcid.org/0000-0002-3222-8566
  • Benoit Godbert Hôpitaux Privés de Metz, Metz, France
  • Julie Perrin Hôpitaux Privés de Metz, Metz, France

Keywords

COVID-19, respiratory distress, phrenic paralysis, neurotropism

Abstract

We describe an overweight COVID-19 patient with respiratory distress preceded by anosmia/dysgeusia with no lung injury shown on CT, angio-CT or ventilation/perfusion scans. Orthopnoea and paradoxical abdominal respiration were identified. Phrenic paralysis, demonstrated by examination of patient breathing, and on x-ray while standing breathing in and out, explained the respiratory distress. This is a rare and previously undescribed neurological complication of COVID-19 infection caused by vagus nerve injury.

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References

  • Matsuda K, Park CH, Sunden Y, Kimura T, Ochiai K, Kida H, et al. The vagus nerve is one route of transneural invasion for intranasally inoculated influenza A virus in mice. Vet Pathol 2004;41(2):101–107.

  • Desforges M, Le Coupanec A, Dubeau P, Bourgouin A, Lajoie L, Dubé M, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 2019;12(1).

  • Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ2020;368:m1091.

  • Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain-Barre syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol 2020;19(5):383–384.

  • Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol 2020;92:552–555.
  • Published: 2020-05-21

    Issue: Vol 7 No 6 (view)

    Section: Articles

    How to cite:
    Maurier, F., Godbert, B., & Perrin, J. (2020). Respiratory Distress in SARS-CoV-2 without Lung Damage: Phrenic Paralysis Should Be Considered in COVID-19 Infection. European Journal of Case Reports in Internal Medicine, 7(6). https://doi.org/10.12890/2020_001728

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