PT - JOURNAL ARTICLE AU - Thomas Simon FitzMaurice AU - Caroline McCann AU - Martin Walshaw AU - James Greenwood TI - Unilateral diaphragm paralysis with COVID-19 infection AID - 10.1136/bcr-2021-243115 DP - 2021 Jun 01 TA - BMJ Case Reports PG - e243115 VI - 14 IP - 6 4099 - http://casereports.bmj.com/content/14/6/e243115.short 4100 - http://casereports.bmj.com/content/14/6/e243115.full SO - BMJ Case Reports2021 Jun 01; 14 AB - Neurological complications are well described in SARS-CoV-2, but for the first time we report a case of unilateral diaphragm paralysis occurring early in mechanical ventilation for respiratory failure due to such an infection. The patient subsequently required tracheostomy and ventilator support for 37 days, and had increased breathlessness and an elevated diaphragm at clinic review 9 months later. Dynamic chest radiography demonstrated persistent diaphragm paralysis with an accompanying postural change in lung volumes, and he subsequently underwent surgical plication. This case demonstrates that although persistent dyspnoea is a common feature following SARS-CoV-2 infection and is usually due to deconditioning or persistent parenchymal involvement, it can be due to other causes and needs to be investigated appropriately.