Persistent unilateral diaphragmatic paralysis in the course of Coronavirus Disease 2019 pneumonia: A case report

Abstract

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.

Keywords

• COVID-19
• diaphragm
• paralysis
• pneumonia
• ARDS