Acute pericarditis as a primary presentation of COVID-19

Abstract

The COVID-19 pandemic is a highly contagious viral illness which conventionally manifests primarily with respiratory symptoms. We report a case whose first manifestation of COVID-19 was pericarditis, in the absence of respiratory symptoms, without any serious complications. Cardiac involvement in various forms is possible in COVID-19. We present a case where pericarditis, in the absence of the classic COVID-19 signs or symptoms, is the only evident manifestation of the disease. This case highlights an atypical presentation of COVID-19 and the need for a high index of suspicion to allow early diagnosis and limit spread by isolation.

Keywords: global health; pericardial disease.

Figure 1

Admission ECG and chest X-ray on day 1. There is minimal ST segment elevation in most leads with PR interval depression.

Figure 2

Transthoracic echocardiogram showing brightened pericardium (white arrows) with no effusion.

Figure 3

Cardiac MRI of the patient with perfusion showing normal left ventricle muscle (black arrows). The pericardium, pointed by white arrows, shows mild thickening (bold white) with no effusion.