A case of a very large haemorrhagic pericardial effusion in an adolescent patient with COVID-19 infection

Gökalp, Selman; Cilsal, Erman; Yükçü, Bekir; Yolcu, Canan; Akkoç, Gülşen; Güzeltaş, Alper

doi:10.1017/s1047951120004850

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…PE, which is the buildup of fluid in the pericardium, is one of the cardiovascular complications of COVID-19 which has rarely been reported - both during and after the viral infection [ 12 , 13 ]. According to the existing literature, most reports of COVID-19 related PE were non-hemorrhagic, with only a few hemorrhagic cases being present [ 9 , 14 ]. This makes COVID-19 the second viral infection that can lead to hemorrhagic PE, in addition to Coxsackievirus [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Post COVID-19 hemorrhagic pericardial effusion; A case report with literature review

Amin¹,

Kakamad

Hamasaeed

et al. 2022

Annals of Medicine &Amp; Surgery

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Introduction Pericardial effusion (PE) related to COVID-19 has rarely been observed, with most reported cases being non-hemorrhagic. This study aims to present a rare case of post-COVID-19 hemorrhagic PE. Case report A 44-year-old male presented with shortness of breath upon exertion, palpitation, and left-sided chest tightness. He was a recently recovered from COVID-19. He was conscious, oriented, tachypneic, and tachycardic. Chest examination revealed a mixture of fine and coarse crackles along with muffled heart sounds. He had elevated D-dimer, C-reactive protein, prothrombin time, and aPTT. Computed tomography pulmonary angiogram showed acute pulmonary thromboembolism involving the posterior segmental lobar branch of the left lower lobe with concomitant pulmonary infarction. Echocardiography showed severe PE without diastolic collapse. Pericardial drainage was performed and by the 2nd day, there was no more effusion. On the 7th day, the patient developed severe complications which led to cardiac arrest. Discussion PE is the buildup of fluid in the pericardium. It has been rarely observed in relation to COVID-19, both during and after the viral infection. If PE is suspected, Echocardiography can be used to confirm its diagnosis. There is no standard management for these cases and only non-hemorrhagic patients with mild to moderate effusion can be treated using conservative measures. Conclusion Hemorrhagic PE can be a rare but possible post-COVID-19 sequel, and Echo can be used to confirm its diagnosis. Drainage is necessary to resolve the effusion.

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Section: Discussionmentioning

confidence: 99%

Post COVID-19 hemorrhagic pericardial effusion; A case report with literature review

Amin¹,

Kakamad

Hamasaeed

et al. 2022

Annals of Medicine &Amp; Surgery

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“…It seems to occur in approximately 2% of all pregnancies [24], but its exact incidence and significance is not clearly understood, because it can be associated with a wide spectrum of aetiologies from severe genetic and chromosomal diseases to transient, "normal" forms [25]. Isolated pericardial effusion has been associated with COVID-19 in adults [3], children [6], and fetuses [7].…”

Section: Discussionmentioning

confidence: 99%

“…COVID-19 can damage the heart. Cardiovascular complications such as myocarditis, pericardial effusion, and pericarditis have been reported in adults [2,3], children [4][5][6], and fetuses [7]. No reports have, thus far, suggested an increase in congenital heart malformations.…”

Section: Introductionmentioning

confidence: 99%

Fetal pericardial effusion after maternal COVID-19 vaccination: a fortuitous association?

Mattos,

Chaves,

Freitas

et al. 2022

pcard

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Introduction: Studies monitoring COVID-19 and its vaccines are warranted to expand knowledge about the virus and its effects in humans. The objective of this study was to compare the reasons for referral and the fetal echocardiographic results during (PAND: Mar/20-Aug/21) and before (PREP: Set/19-Feb/20) the COVID-19 pandemic. Material and methods: Single outpatient centre, retrospective study. Results: A total of 10,778 fetal echocardiograms were performed; 10,732 corresponding to initial examinations performed in 10,551 pregnancies (10,376 singletons; 171 twins; 2 triplets; 2 quadruplets). Only first-time exams were reviewed. There were 5652 during PREP and 5080 during PAND. Maternal ages (X) varied between 14 and 46 years (X -PREP = 29.1and X -PAND = 29.2), and gestational weeks (Y) varied between 16 and 39 weeks (Y -PREP = 26.9 and Y -PAND = 27.6). The exams were not performed in women with known active COVID-19 infection. In PREP, more women were referred due to maternal or fetal risk factors. During PAND, more women were referred due to a suspected heart defect on ultrasound. During PAND we identified more fetuses with congenital heart disease and arrhythmias. A higher incidence of pericardial effusion, without structural heart disease, was observed during the months of June, July, and August 2021, compared to the remaining months (p < 0.001). Conclusions: The identification of more structural heart disease during PAND may reflect changes in referral patterns. The increase in isolated pericardial effusion coincided with the period of massive COVID-19 immunization. We hypothesize that this finding may reflect a transient inflammatory response that could signal to fetal immunization against SARS-CoV-2.

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“…Large and hemorrhagic pericardial effusions are commonly associated with malignancy (about 26%), PCI procedures, and complications of myocardial infarctions [1]. SARS-CoV-2 has been associated with hemorrhagic pericardial effusions in recent literature [3][4][5]. The mechanism of the hemorrhagic effusion is hypothesized to be due to direct cardiomyocyte and pericardium invasion by binding of the angiotensin-converting enzyme-2 (ACE2) receptor that promotes inflammation, cytokine release, fibrosis, vasoconstriction, and oxidative stress in the setting of adult respiratory distress syndrome (ARDS) [6].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Complicated by a Large Hemorrhagic Pericardial Effusion

Abdelsayed¹,

Mckinney²,

Carter³

2022

Cureus

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Severe acute respiratory syndrome coronavirus (SARS-CoV-2), primarily a respiratory virus, has also presented with cardiac complications including myocarditis, myocardial infarction, and cardiac arrhythmias. Pericardial effusions are also emerging in the literature as a sequel to this viral infection. A case of a 57-yearold Hispanic female with SARS-CoV-2 infection two months prior with worsening dyspnea on exertion who was found to have a large hemorrhagic pericardial effusion with early tamponade physiology was presented in this article. This case highlights the rare complication and the importance of bedside echocardiogram in patients with recent SARS-CoV-2 infection who present with shortness of breath and other signs of pericardial effusion.

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A case of a very large haemorrhagic pericardial effusion in an adolescent patient with COVID-19 infection

Cited by 8 publications

References 9 publications

Post COVID-19 hemorrhagic pericardial effusion; A case report with literature review

Post COVID-19 hemorrhagic pericardial effusion; A case report with literature review

Fetal pericardial effusion after maternal COVID-19 vaccination: a fortuitous association?

SARS-CoV-2 Complicated by a Large Hemorrhagic Pericardial Effusion

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