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Coronavirus Disease 2019 (COVID-19) and Severe Pericardial Effusion: From Pathogenesis to Management: A Case Report

Mohammad Kermani-Alghoraishi1, Alireza Pouramini1, Fatemeh Kafi2

  • 1Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Current Problems in Cardiology
|August 18, 2021
PubMed

Insights

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can cause life-threatening pericardial effusion in COVID-19 patients. This review examines its varied presentations and emphasizes the need for medical management and follow-up.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, extends beyond respiratory symptoms to affect cardiac health.
  • Pericardial effusion, particularly large effusions causing tamponade, is a critical complication observed in some COVID-19 patients.

Observation:

  • This systematic review analyzes case reports of moderate to severe pericardial effusion with tamponade physiology in COVID-19.
  • Pathogenesis involves direct viral invasion, inflammation, cytokine storms, and oxidative stress from ARDS.

Findings:

  • Pericardial effusion manifestations are variable, appearing as delayed complications, with myocarditis/pericarditis, isolated, or with ARDS.
  • Percutaneous pericardiocentesis was frequently performed, revealing exudative fluid (hemorrhagic, serous, or serosanguinous).

Implications:

  • Understanding the varied presentations of SARS-CoV-2-associated pericardial effusion is crucial for timely diagnosis.
  • Medical treatment and close follow-up are recommended, particularly for patients with concurrent pericarditis.

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