[Platypnea-orthodeoxia syndrome secondary to pneumonia: Two cases]. / Syndrome platypnée-orthodéoxie secondaire à une pneumopathie : à propos de deux cas.

INTRODUCTION: The platypnea-orthodeoxia syndrome is a rare situation characterized by the appearance of dyspnea and/or hypoxemia during the transition to orthostatism. OBSERVATIONS: We report the case of two patients, who presented with a platypnea-orthodeoxia syndrome following pneumocystis pneumonia and COVID-19, revealing an intracardiac communication with a right-left shunt on contrast ultrasound. CONCLUSION: This syndrome can be detected easily at the bedside with positional maneuvers and the shunt demonstrated by a hyperoxia test. Non-reversible situations may require correction of the anatomical anomaly by transcatheter intervention or surgery.

[Caregivers are also concerned by the Covid long]. / Les soignants aussi sont concernés par le Covid long.

In the front line, from the beginning of the pandemic, to take care of patients hospitalized for severe forms of Covid-19, health professionals have not failed, despite the precautions taken, to contract the virus and develop the disease, sometimes with severe forms. Two hospital caregivers testify about their respective experiences and the repercussions on their daily life due to a long Covid.

Perspectives post-COVID-19 : le point de vue des pneumologues

Résumé Plus de 5 millions de personnes en France ont présenté une infection par le SARS-CoV-2. Lors des précédentes épidémies de coronavirus (SARS-CoV, Mers-CoV), les patients ont développé des séquelles pulmonaires avec une dyspnée, une diminution de la capacité de diffusion du monoxyde de carbone et/ou des lésions de fibrose. Le but de cette revue était d’évaluer les séquelles respiratoires et de faire une synthèse des principaux symptômes respiratoires après une infection au COVID-19 et de leurs étiologies. Les quatre principales causes de dyspnée sont les séquelles respiratoires, le déconditionnement, l’hyperventilation et les causes classiques de dyspnée. Les principales séquelles respiratoires étaient l’altération de la capacité de diffusion du monoxyde de carbone et le schéma de fibrose. La prévalence de ces séquelles respiratoires est actuellement inconnue. Summary More than 5 millions of people in France have presented a SARS-CoV-2 infection. In the previous coronavirus epidemics (SARS-CoV, Mers-CoV), patients have developed pulmonary sequelae with dyspnoea, DLCO decrease and/or fibrosis lesions. The purpose of this review was to evaluate the respiratory sequelae and to do a summary of the main respiratory symptoms after a COVID-19 infection and their aetiologies. The four main causes of dyspnoea are respiratory sequelae, deconditioning, hyperventilation and classical causes of dyspnoea. The main respiratory sequelae were DLCO alteration and fibrosis pattern. Actually, the prevalence of these respiratory sequelae is unknown.

[Parsonage-Turner syndrome following severe SARS-CoV-2 infection]. / Syndrome de Parsonage-Turner compliquant une infection sévère à SARS-CoV-2.

INTRODUCTION: Complications following COVID-19 are starting to emerge; neurological disorders are already described in the literature. CASE REPORT: This case is about a 20-year old male with a severe COVID-19, hospitalized in a Reanimation and Intensive Care Unit with an Acute Respiratory Distress Syndrome, thromboembolic complication and secondary bacterial infection. This patient had a non-specific neurological disorder with a pseudobulbar palsy, (MRI, ENMG and lumbar puncture were normal), associated 4 months later with persistent left shoulder motor deficit and respiratory failure. Respiratory and neurological check-up led to a diagnosis of the Parsonage-Turner syndrome or neuralgic amyotrophy affecting C5-C6 nerve roots, the lateral pectoral and phrenic nerves at the origin of the scapular belt, amyotrophy and left diaphragm paralysis. CONCLUSIONS: This case shows that persistant dyspnoea after COVID 19 infection should lead to a search for a diaphragmatic cause which is not always the result of Reanimation Neuropathy but may also indicate a neuralgic amyotrophy. It is the fourth case of neuralgic amyotrophy following COVID-19. This brings the medical community to consider the risk of diaphragm paralysis apart from critical illness polyneuropathy. Respiratory muscle evaluation and diaphragmatic ultrasound should be considered in case of persistent dyspnoea.