A strange case of severe but fleeting hypoxemia in patient with COVID-19 infection: maybe virus-induced pulmonary Raynaud’s phenomenon?




This case-report describes severe acute respiratory failure in a patient with a COVID-19 positive nasopharyngeal swab that spontaneously resolved within a few hours. It is speculated that the virus may have caused a fleeting pulmonary vasospasm.



PlumX Metrics


Download data is not yet available.


Lombardy Region. Official Bulletin March 18th, 2020. Available from: https://www.open.online/2020/03/18/coronavirus-bollettino-regione-lombardia-18-marzo

Grasselli G, Tonetti T, Protti A, et al. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study. Lancet Respir Med 2020;8:1201-8. DOI: https://doi.org/10.1016/S2213-2600(20)30370-2

Bunce PE, High SM, Nadjafi M, et al. Pandemic H1N1 influenza infection and vascular thrombosis. Clin Infect Dis 2011;52:e14-7. DOI: https://doi.org/10.1093/cid/ciq125

O'Driscoll BR, Howard LS, Earis J, et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax 2017;72:i1-i90. DOI: https://doi.org/10.1136/thoraxjnl-2016-209729

Humbert M, Monti G, Fartoukh M, et al. Platelet-derived growth factor expression in primary pulmonary hypertension: comparison of HIV seropositive and HIV seronegative patients. Eur Respir J 1998;11:554-9.

Ehrenreich H, Rieckmann P, Sinowatz F, et al. Potent stimulation of monocytic endothelin-1 production by HIV-1 glycoprotein 120. J Immunol 1993;150:4601-9.

Palazzini M, Manes A, Negro L, et al. Pulmonary arterial hypertension. Part I: pathobiologic, pathophysiologic, clinical and diagnostic aspects. G Ital Cardiol 2009;10:271-300.

Jung F, Krüger-Genge A, Franke RP, et al. COVID-19 and the endothelium. Clin Hemorheol Microcirc 2020;75:7-11. DOI: https://doi.org/10.3233/CH-209007

Budhiraja R, Tuder RM, Hassoun PM. Endothelial dysfunction in pulmonary hypertension. Circulation 2004;109:159-65. DOI: https://doi.org/10.1161/01.CIR.0000102381.57477.50

Hervé P, Launay JM, Scrobohaci ML, et al. Increased plasma serotonin in primary pulmonary hypertension. Am J Med 1995;99:249-54. DOI: https://doi.org/10.1016/S0002-9343(99)80156-9

Petkov V, Mosgoeller W, Ziesche R, et al. Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension. J Clin Invest 2003;111:1339-46. DOI: https://doi.org/10.1172/JCI17500

Teman NR, Thomas J, Bryner BS, et al. Inhaled nitric oxide to improve oxygenation for safe critical care transport of adults with severe hypoxemia. Am J Crit Care 2015;24:110-7. DOI: https://doi.org/10.4037/ajcc2015570

Akerström S, Gunalan V, Keng CT, et al. Dual effect of nitric oxide on SARS-CoV replication: viral RNA production and palmitoylation of the S protein are affected. Virology 2009;395:1-9. DOI: https://doi.org/10.1016/j.virol.2009.09.007

Chen L, Liu P, Gao H, et al. Inhalation of nitric oxide in the treatment of severe acute respiratory syndrome: a rescue trial in Beijing. Clin Infect Dis 2004;39:1531-5. DOI: https://doi.org/10.1086/425357

Adusumilli NC, Zhang D, Friedman JM, Friedman AJ. Harnessing nitric oxide for preventing, limiting and treating the severe pulmonary consequences of COVID-19. Nitric Oxide 2020;103:4-8. DOI: https://doi.org/10.1016/j.niox.2020.07.003


COVID-19 - Collection of articles on the Coronavirus outbreak
SARS-CoV-2, COVID-19, respiratory failure, pathogenesis
  • Abstract views: 318

  • PDF: 114
How to Cite
Barbarito, Nicola. 2021. “A Strange Case of Severe But Fleeting Hypoxemia in Patient With COVID-19 Infection: Maybe Virus-Induced Pulmonary Raynaud’s Phenomenon?”. Monaldi Archives for Chest Disease 91 (2). https://doi.org/10.4081/monaldi.2021.1706.