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Systemic Lupus Erythematosus (SLE) is a chronic multisystem autoimmune disease. Serositis occurs in 16% of SLE patients, and while cardiac tamponade and acute peritonitis with ascites can occur during the course of the disease, they are rare as the first presentation. A 25-year-old woman presented to the emergency department in Tishreen Hospital with complaints of dyspnea, fever, chills, and chest and abdominal pain. Two months prior, she suffered from musculoskeletal pain, fatigue, anorexia, weight loss of about 15 kg, severe hair loss, and recurrent oral aphthous. On clinical examination, the patient was pale and tired with dyspnea and pitting edema (grade 3–4). Pericardiocentesis was emergently performed because there were signs of cardiac tamponade. Three days later, the patient developed an acute surgical abdomen due to acute peritonitis and ascites. Later, the patient was diagnosed with SLE after excluding malignant and infectious diseases. Consequently, methylprednisolone pulses, azathioprine, and hydroxychloroquine 200 mg/day were introduced immediately. The clinical status of the patient dramatically improved, and three months later, the patient was symptom-free with normal laboratory tests. In conclusion, although cardiac tamponade and acute surgical abdomen because of acute peritonitis and ascites as the initial presentation of SLE are very rare, they can occur coincidently.

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Background: A recent ongoing pandemic of coronavirus disease named coronavirus disease 2019 (COVID-19) has spread in Syria from March 2020 with a pattern of a slow case increase. So far, the government has put the country under lock-down orders as a preventive measure. However, there is a considerable belief in the medical community of our country supposes that the virus has previously passed through the country depending on the high numbers of diagnosed severe respiratory infections early in 2020. Thus, this study was designed to determine the number of people with detectable antibodies to SARS-CoV-2 from two samples of healthy adults with and without a previous history of severe respiratory infection in the last 6 months of the study. Materials and Methods: To this end, samples were collected from 123 and 198 subjects with a previous severe respiratory infection and healthy controls, respectively. Then, immunoglobulin M (IgM) and IgG anti-SARS-CoV-2 antibodies were tested as well. Results: None of the samples from both groups tested IgG positive in the assay while four tested IgM samples were positive. Accordingly, these positive samples were re-analyzed and remained IgM positive in the second test although the reverse transcriptase-polymerase chain reaction for the SARS-CoV-2 virus was negative. Conclusion: Based on our findings, there is no evidence concerning the previous COVID-19 infection in Syria thus it is suggested that all isolation and lock-down orders should be respected as an effective preventive tool in this regard.