Pericardial eff usion as a new specifi c symptom of SARS-CoV-2

Abstract

Being a consequence of COVID-19, cardiovascular disorders are now at the forefront of the infection’s after-eff ects. Researchers note the involvement of heart muscle, vascular endothelium, cardiac conduction system into the infectious infl ammation even if a person has oligosymptomatic SARS-CoV-2. On the other hand, we still do not have a clear understanding of the genesis of the long-standing persistent hyperthermia, reduced stamina and atypical cardialgia.Objective. The study demonstrates the high frequency of pericardial eff usion among patients who recovered from COVID-19. The study describes clinical symptoms of the COVID-19-induced pericarditis.Materials and methods. To compare the frequency of pericardial eff usion (based on TTE data) among a sample of patients who recovered from COVID-19 and in the control group of patients who were examined before the pandemic, the study was conducted in accordance with STROBE design. The main group, studied on a prospective basis, included patients who recovered from COVID-19 1 or 2 months ago. The control group was made up retrospectively from the database of the Functional Diagnostics Department for January–February 2019, matching the main group in terms of gender and age. The groups had no diff erence in terms of high blood pressure, ischemic heart disease, Index of Mass Corporal. Hence, 110 pairs of patients were selected from the two groups, where we analyzed TTE results following the event-control protocol.Results. The cohort of patients who recovered from COVID-19 consisted of 51 men and 59 women, with the average age of 67 ± 9 years old. 30 patients had moderate and severe forms of COVID-19 and were hospitalized. 80 ones had a mild form of COVID-19 confi rmed with PCR test or COVID-19 antibody testing and were monitored on the outpatient basis. The average time of the study spans 5 ± 1 weeks after the fi rst symptoms onset. The control group comprised 110 patients aged 67 ± 5 years. Signs of pericardial eff usion were recorded as part of TTE in 47 (43%) patients from the main group, with 5 of them (11%) having chronic causes for the eff usion. In the control group, the hydropericardium was detected in 4 (3%) patients. The rate ratio is 19,8 (95 OR 18.2–21.6). The frequency of hydropericardium symptoms did not depend on the age, principal cardiovascular diseases and the severity of COVID-19. Pericardial eff usion of the COVID-19 origin had some diff erence in ultrasound imaging as compared to pericardial eff usion of non-COVID-19 origin. The additional anti-infl ammatory therapy was prescribed for such patients.Conclusions. The hydropericardium should be viewed as a specifi c manifestation of SARSCoV-2 and taken into account when assessing the post-COVID-19 symptoms. Pericardial eff usion is found after COVID-19 12 times as frequent as in the demographically comparable group without the pandemic. Despite the severity of COVID-19, the high frequency of pericardial eff usion necessitates TTE assessment in dynamics throughout at least 2 months after the infection.