Right to Left Intrapulmonary Shunt in a Case with COVID-19-associated Pneumonia

ABSTRACT       The clinical manifestations of coronavirus disease 2019 (COVID-19)-associated pneumonia show a wide range variations. It ranges from mild hypoxemia without significant signs respiratory distress, to rapid clinically deteriorating course with severe hypoxemia. Unexplained hypoxemia, associated platypnea, triggers the possibility ventilation-perfusion (V/Q) mismatch, ranging intrapulmonary shunts (IPS) alveolar dead space ventilation. In literature, very few cases COVID-19-pneumonia have been reported IPS. Herein, we report COVID-19 confirmed 45-year male patient, who developed IPS apparent pulmonary perfusion defect on lung scintigraphy. patient had no cardiovascular except chronic hypertension secondary interstitial disease. combined nuclear imaging features enabled in making ultimate diagnosis. patient's condition improved appropriate management, using high flow oxygen intravenous steroids and anticoagulants. Key Words: COVID-19, Adult distress syndrome, Right left shunt, Lung scintigraphy, Platypnea.