A Rare Case of Acute Pericarditis Due to SARS-CoV-2 Managed With Aspirin and Colchicine

Thrupthi, Komandur; Ganti, Adithya; Acherjee, Trishna; Mehmood, Maham; Vakde, Trupti

doi:10.7759/cureus.12534

Cited by 5 publications

(30 citation statements)

References 16 publications

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“…A multitude of international clinical trials also indicates that colchicine poses improved outcomes for SARS-COV2 pericarditis specifically [14]. A successful response to colchicine and concomitant aspirin therapy are also noted from recent case reports in addition to the case presented above [15]. Steroidal therapy is contraindicated in patients with pericarditis, due to concerns for an increased risk of recurrence [16].…”

Section: Discussionmentioning

confidence: 92%

Acute Pericarditis Due to SARS-COV-2 in a Kidney Transplant Recipient

Gill¹,

Beinhoff²,

Lamberg³

et al. 2021

Cureus

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly contagious and typically presents with respiratory complications. Non-respiratory etiology has been increasingly identified in the literature, including cardiac manifestations. Here, we discuss an atypical case recently treated for SARS-CoV-2 presenting with acute pericarditis. Our patient's medical history of autoimmune disease and renal transplant further complicated her care. There is currently no standard of therapy for SARS-CoV-2-related pericarditis. We would like to highlight increased awareness of this rare complication as well as successful treatment regimens for acute management of the disease.

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Section: Discussionmentioning

confidence: 92%

Acute Pericarditis Due to SARS-COV-2 in a Kidney Transplant Recipient

Gill¹,

Beinhoff²,

Lamberg³

et al. 2021

Cureus

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“…The common theme of the studies was either the identification of only pericarditis [10,11,14,16,19,23,26,28,30,35,37,38,40], myopericarditis [13,18,20,21,24,25,29,33,34], or the association of cardiac tamponade or pericardial effusion and either pericarditis or myopericarditis [9,12,15,17,22,27,31,32,36,39,41] in COVID-19 patients.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…In total, 29 articles selected for this study were case reports [9][10][11][12][13][14][15][17][18][19][20][22][23][24][25][26][27][28][29][30][31][32][33][34][35][38][39][40][41] while four were case series [16,21,36,37]. All articles were published in 2020 [9][10][11]13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All articles were published in 2020 [9][10][11]13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][31][32][33][34][35][36][37][39][40][41], except four, which were published in 2021 [12,14,30,38]. The majority of the studies were conducted in the United States [9,10,15,16,[20][21][22]25,[30][31][32][38][39][40][41], followed by countries from the European Union or United kingdom [11,12,18,…”

Section: Study Characteristicsmentioning

confidence: 99%

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A Systematic Review of COVID-19 and Pericarditis

Kariyanna¹,

Ahmed²,

Sutarjono³

et al. 2022

Cureus

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Coronavirus disease 2019 , caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China in December 2019. Since then, the disease has spread globally, leading to the ongoing pandemic. It can cause severe respiratory illness; however, many cases of pericarditis have also been reported. This systematic review aims to recognize the clinical features of pericarditis and myopericarditis in COVID-19 patients.Google Scholar, Medline/PubMed, CINAHL, Cochrane Central, and Web of Science databases were searched for studies reporting "Coronavirus" or "COVID" and "Peri-myocarditis," "heart," or "retrospective." Case reports and retrospective studies published from May 2020 to February 2021 were reviewed.In total, 33 studies on pericarditis, myopericarditis, and pericardial infusion were included in this review. COVID-19 pericarditis affected adult patients at any age. The incidence is more common in males, with a male-to-female ratio of 2:1. Chest pain (60%), fever (51%), and shortness of breath (51%) were the most reported symptoms, followed by cough (39%), fatigue (15%), myalgia (12%), and diarrhea (12%). Laboratory tests revealed leukocytosis with neutrophil predominance, elevated D-dimer, erythrocyte rate, and Creactive protein. Cardiac markers including troponin-1, troponin-T, and brain natriuretic peptide were elevated in most cases. Radiographic imaging of the chest were mostly normal, and only 31% of chest X-rays showed cardiomegaly and or bilateral infiltration. Electrocardiography (ECG) demonstrated normal sinus rhythm with around 59% ST elevation and rarely PR depression or T wave inversion, while the predominant echocardiographic feature was pericardial effusion. Management with colchicine was favored in most cases, followed by non-steroidal anti-inflammatory drugs (NSAIDs), and interventional therapy was only needed when patient developed cardiac tamponade. The majority of the reviewed studies reported either recovery or no continued clinical deterioration.The prevalence of COVID-19-related cardiac diseases is high, and pericarditis is a known extrapulmonary manifestation. However, pericardial effusion and cardiac tamponade are less prevalent and may require urgent intervention to prevent mortality. Pericarditis should be considered in patients with chest pain, ST elevation on ECG, a normal coronary angiogram, and COVID-19. We emphasize the importance of clinical examination, ECG, and echocardiogram for decision-making, and NSAIDs, colchicine, and corticosteroids are considered to be safe in the treatment of pericarditis/myopericarditis associated with COVID-19.

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“…Unless formal anticoagulation is indicated, (per guidelines contingent upon D-Dimer levels), we recommend 1 baby aspirin daily (81 mg) for purposes of reducing clot and sludging via platelet inhibition (unless aspirin in the patient is contraindicated). [68][69][70][71][72][73][74][75][76][77]…”

Section: Baby Aspirinmentioning

confidence: 99%

Application of an evidence-based, out-patient treatment strategy for COVID-19: Multidisciplinary medical practice principles to prevent severe disease

Frohman

Villemarette-Pittman

Rodríguez

et al. 2021

Journal of the Neurological Sciences

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The COVID-19 pandemic has devastated individuals, families, and institutions throughout the world. Despite the breakneck speed of vaccine development, the human population remains at risk of further devastation. The decision to not become vaccinated, the protracted rollout of available vaccine, vaccine failure, mutational forms of the SARS virus, which may exhibit mounting resistance to our molecular strike at only one form of the viral family, and the rapid ability of the virus(es) to hitch a ride on our global transportation systems, means that we are will likely continue to confront an invisible, yet devastating foe. The enemy targets one of our human physiology's most important and vulnerable life-preserving body tissue; our brocho-alveolar gas exchange apparatus. Notwithstanding the fear and the fury of this microbe's potential to raise existential questions across the entire spectrum of human endeavor, the application of an early treatment intervention initiative, may represent a crucial tool in our defensive strategy. This strategy is driven by evidence-based medical practice principles, those not likely to become antiquated, given the molecular diversity and mutational evolution of this very clever “world traveler” .

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A Rare Case of Acute Pericarditis Due to SARS-CoV-2 Managed With Aspirin and Colchicine

Cited by 5 publications

References 16 publications

Acute Pericarditis Due to SARS-COV-2 in a Kidney Transplant Recipient

Acute Pericarditis Due to SARS-COV-2 in a Kidney Transplant Recipient

A Systematic Review of COVID-19 and Pericarditis

Application of an evidence-based, out-patient treatment strategy for COVID-19: Multidisciplinary medical practice principles to prevent severe disease

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