Abstract
AIMS: Acute pericarditis is considered one of the cardiovascular complications of COVID-19. The published data suggest that the diagnosis of acute pericarditis in patients with COVID-19 infection may be more frequent than usually diagnosed and as a consequence, undertreated. The proposed investigation is a retrospective observational study in which 170 patients, admitted to an Intensive Care Unit because of a COVID-19 diagnosis, were analysed. All patients underwent cardiological evaluation including a bedside echocardiogram. The aim of the study was to evaluate the prevalence and clinical implications of acute pericarditis diagnosed through the presence of pericardial effusion. METHODS AND RESULTS: The proposed investigation is a retrospective observational study enrolling patients admitted to Intensive Care Unit of Madonna del Soccorso Hospital (San Benedetto del Tronto, Italy) because of a SARS-CoV-2 induced severe acute respiratory syndrome. No. 170 patients, admitted from 1 April 2020 to 30 April 2021, were enrolled. All patients presented a variable picture of bilateral interstitial pneumonia characterized by ground glass opacifications at HR-Chest CT. Some patients underwent oro-tracheal intubation and invasive ventilation. All patients underwent cardiological consultation including a transthoracic bedside echocardiogram, using ultrasound E9-GE machine (Boston, MA, USA). Demographic, laboratory and clinical data were collected for all enrolled patients (Table 1). The diagnosis of acute pericarditis was defined by: (i) different degree of pericardial effusion; (ii) C-reactive proteine elevation. All patients were divided in two groups: (1) pericarditis group (a); (2) pericarditis-free group (b). Of 170 enrolled patient, 51 were females (30%) and 119 were males (70%). Median age for all patients was 67.6 ± 13.3 [females: 70.5 (±16.2); males: 66.4 (±11.7)]. Of 170, n. 60 patients had a diagnosis of acute pericarditis (32.2%). Group A (patient with acute pericarditis) consisted of 60 patients, age 69.2 (±12.6), 39 (65%) male [age 69.3 (±10.6)], 21 (35%) female [age 69.1 (±16.0)]. Of 60, only 6 had a pericardial effusion >10 mm (10%); the remaining group A-patients (90%) had a mild pericardial effusion (<10 mm). No patient had tamponade picture. Group B (pericarditis-free patients) included 110 patients, age 66.7 (±13.7), 80 (72.7%) males [age 65.0 (±12.1)], 30 (27.3%) females [age 71.4 (±16.6)]. Group A-patients (with pericarditis) had more days of intubation and a prolonged global hospital stay compared with group B (pericarditis-free). Other demographic, clinical and laboratory parameters were similar between the two groups. CONCLUSIONS: Pericarditis is a frequent cardiovascular complication of COVID-19 (32.2% in our study). It may have clinical and prognostic implications.