Pericarditis related to post-acute COVID infection: A case report and review of the literature

Nguyen, Nhu Ngoc and Dudouet, Pierre and Dhiver, Catherine and Gautret, Philippe (2023) Pericarditis related to post-acute COVID infection: A case report and review of the literature. ACTA MICROBIOLOGICA ET IMMUNOLOGICA HUNGARICA, 70 (2). pp. 100-110. ISSN 1217-8950

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Abstract

Cardiovascular involvement has been described in acute and recovered COVID-19 patients. Here, we present a case of symptomatic pericarditis with persistent symptoms for at least six months after the acute infection and report 66 published cases of pericarditis in discharged COVID patients. Patient mean age & PLUSMN; SD was 49.7 & PLUSMN; 13.3 years, ranging from 15 to 75 years and 57.6% were female. A proportion of 89.4% patients reported at least one comorbidity, with autoimmune and allergic disorders, hyper-tension and dyslipidaemia, as the most frequent. Only 8.3% of patients experienced severe symptoms of acute COVID-19. The time between acute COVID and pericarditis symptoms varied from 14 to 255 days. Chest pain (90.9%), tachycardia (60.0%) and dyspnoea (38.2%) were the most frequent symptoms in post-acute pericarditis. A proportion of 45.5% and 87% of patients had an abnormal electrocar-diogram and abnormal transthoracic ultrasound, respectively. Colchicine combined with non-steroidal anti-inflammatory drug (NSAID) or acetylsalicylic acid (aspirin) were prescribed to 39/54 (72%) patients. Of them, 12 were switched to corticosteroid therapy due to non-response to the first-line treatment. Only 6 patients had persisting symptoms and were considered as non-respondent to therapy. Our report highlights that pericarditis should be suspected in COVID-19 patients with persistent chest pain and dyspnoea when pulmonary function is normal. Treatment with non-steroidal anti-in-flammatory and colchicine is usually effective but corticosteroids are sometimes required.

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