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. 2023 Mar 1:374:129-134.
doi: 10.1016/j.ijcard.2022.12.019. Epub 2022 Dec 10.

Acute pericarditis as a major clinical manifestation of long COVID-19 syndrome

Frank Lloyd Dini  1 , Umberto Baldini  2 , Ibadete Bytyçi  3 , Nicola Riccardo Pugliese  4 , Gani Bajraktari  3 , Michael Y Henein  5
Affiliations

Acute pericarditis as a major clinical manifestation of long COVID-19 syndrome

Frank Lloyd Dini et al. Int J Cardiol. .

Abstract

Background: The long COVID-19 syndrome has been recently described and some reports have suggested that acute pericarditis represents important manifestation of long COVID-19 syndrome. The aim of this study was to identify the prevalence and clinical characteristics of patients with long COVID-19, presenting with acute pericarditis.

Methods: We retrospectively included 180 patients (median age 47 years, 62% female) previously diagnosed with COVID-19, exhibiting persistence or new-onset symptoms ≥12 weeks from a negative naso-pharyngeal SARS CoV2 swamp test. The original diagnosis of COVID-19 infection was determined by a positive swab. All patients had undergone a thorough physical examination. Patients with suspected heart involvement were referred to a complete cardiovascular evaluation. Echocardiography was performed based on clinical need and diagnosis of acute pericarditis was achieved according to current guidelines.

Results: Among the study population, shortness of breath/fatigue was reported in 52%, chest pain/discomfort in 34% and heart palpitations/arrhythmias in 37%. Diagnosis of acute pericarditis was made in 39 patients (22%). Mild-to-moderate pericardial effusion was reported in 12, while thickened and bright pericardial layers with small effusions (< 5 mm) with or without comet tails arising from the pericardium (pericardial B-lines) in 27. Heart palpitations/arrhythmias (OR:3.748, p = 0.0030), and autoimmune disease and allergic disorders (OR:4.147, p = 0.0073) were independently related to the diagnosis of acute pericarditis, with a borderline contribution of less likelihood of hospitalization during COVID-19 (OR: 0.100, p = 0.0512).

Conclusion: Our findings suggest a high prevalence of acute pericarditis in patients with long COVID-19 syndrome. Autoimmune and allergic disorders, and palpitations/arrhythmias were frequently associated with pericardial disease.

Keywords: Acute pericarditis; COVID-19; SARS-CoV2.

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Figures

Fig. 1
Fig. 1
Echocardiographic parasternal long axis view showing a thickened pericardium with an effusion of 10 mm between the layers.
Fig. 2
Fig. 2
Increased echogenity of the pericardium in the left basal segments with thickened layers and numerous comet tails (pericardial B-lines). A. Short-axis view. B. Long-axis view.
Fig. 3
Fig. 3
Histograms describing prevalence of autoimmune and allergic disorders in long COVID-19 patients with or without pericarditis.
See this image and copyright information in PMC

Comment in

  • Pericarditis in long COVID-19.
    Carbone RG, Puppo F. Carbone RG, et al. Int J Cardiol. 2023 Apr 1;376:156. doi: 10.1016/j.ijcard.2023.01.087. Epub 2023 Feb 7. Int J Cardiol. 2023. PMID: 36758864 Free PMC article. No abstract available.

References

    1. Carfì A., Bernabei R., Landi F., Gemelli Against COVID-19 Post-Acute Care Study Group Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324(6):603–605. doi: 10.1001/jama.2020.12603. (PMID: 32644129; PMCID: PMC7349096) - DOI - PMC - PubMed
    1. Jacobs L.G., Gourna Paleoudis E., Lesky-Di Bari D., Nyirenda T., Friedman T., Gupta A., Rasouli L., Zetkulic M., Balani B., Ogedegbe C., Bawa H., Berrol L., Qureshi N., Aschner J.L. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS One. 2020;15(12) doi: 10.1371/journal.pone.0243882. (PMID: 33306721; PMCID: PMC7732078) - DOI - PMC - PubMed
    1. Munblit D., Bobkova P., Spiridonova E., Shikhaleva A., Gamirova A., Blyuss O., Nekliudov N., Bugaeva P., Andreeva M., Dunn Galvin A., Comberiati P., Apfelbacher C., Genuneit J., Avdeev S., Kapustina V., Guekht A., Fomin V., Svistunov A.A., Timashev P., Subbot V.S., Royuk V.V., Drake T.M., Hanson S.W., Merson L., Carson G., Horby P., Sigfrid L., Scott J.T., Semple M.G., Warner J.O., Vos T., Olliaro P., Glybochko P., Butnaru D., Sechenov StopCOVID Research Team Incidence and risk factors for persistent symptoms in adults previously hospitalized for COVID-19. Clin Exp Allergy. 2021;51(9):1107–1120. doi: 10.1111/cea.13997. (Epub 2021 Aug 12. PMID: 34351016; PMCID: PMC8444748) - DOI - PMC - PubMed
    1. Boscolo-Rizzo P., Guida F., Polesel J., Marcuzzo A.V., Capriotti V., D’Alessandro A., Zanelli E., Marzolino R., Lazzarin C., Antonucci P., Sacchet E., Tofanelli M., Borsetto D., Gardenal N., Pengo M., Tirelli G. Sequelae in adults at 12 months after mild-to-moderate coronavirus disease 2019 (COVID-19) Int Forum Allergy Rhinol. 2021 doi: 10.1002/alr.22832. (Epub ahead of print. PMID: 34109765) - DOI - PMC - PubMed
    1. Dixit N.M., Churchill A., Nsair A., Hsu J.J. Post-acute COVID-19 syndrome and the cardiovascular system: what is known? Am Heart J Plus. 2021;5 doi: 10.1016/j.ahjo.2021.100025. (Epub 2021 Jun 24. PMID: 34192289; PMCID: PMC8223036) - DOI - PMC - PubMed