• Dysrhythmias
• Acute-COVID-19
• Cardiovascular manifestations
• Heart failure
• Myocardial injury
• Post-COVID-19

• Humans
• COVID-19/complications
• COVID-19/epidemiology
• COVID-19/therapy
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• SARS-CoV-2
• Post-Acute COVID-19 Syndrome
• Risk Factors
• Acute Disease

• Atypical presentation
• COVID-19
• Older adults
• SARS-CoV-2
• Scoping review
• Signs
• Symptoms

• Acute pericarditis
• COVID-19
• CT scan
• Cardiovascular complications
• Guillain–Barré syndrome
• Respiratory infection

• COVID-19
• SARS-CoV-2
• brain
• elderly
• heart
• inflammation
• kidney
• lung
• neuropathology

• Aged
• Antigens, Viral
• Brain/pathology
• COVID-19
• Humans
• Kidney
• Lung/pathology
• Macrophages
• RNA, Viral
• SARS-CoV-2
• T-Lymphocytes
• Thrombosis/pathology

Coronavirus disease 2019 (COVID-19), 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 C-reactive 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.

Patient with rheumatoid arthritis who has Covid-19 with recurrent pericaditis debut, differential diagnosis.

• Arthritis, Rheumatoid/complications
• COVID-19/complications
• Diagnosis, Differential
• Humans
• Pericarditis/etiology

The ST-segment elevation is commonly associated with acute myocardial Infarction. However, there are other non-ischemic causes of ST-elevation. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious illness that continues to plague the world since the first case was reported in China over two years ago. As cases of the diseases become rampant, we have learned more of its complications which can include cardiac and pericardial disease. We present a case report of a young African American male who presented with chest pain six weeks after being diagnosed with SARS-Cov-2 pneumonia. Electrocardiogram (EKG) showed ST-segment changes that were initially presumed to be acute pericarditis. The patient was initially treated with colchicine. After further workup and a second opinion, ST-segment changes were thought to be likely benign early repolarization changes rather than pericarditis. Differential diagnosis of ST-segment changes on EKG in the patient with chest pain is broad. Subtle findings on EKG are important in distinguishing these differentials and should be well known and understood.

Coronavirus disease 2019 (COVID-19) is a highly contagious viral illness which conventionally manifests with primarily respiratory symptoms and less commonly with cardiac involvement in various forms, such as pericarditis. Myocarditis and pericarditis have been reported in a variety of live and attenuated vaccines, such as smallpox and influenza. As of October 2021, no cases of pericarditis associated with COVID-19 vaccination have been published. We present two healthy male patients who present post COVID-19 vaccination with pericarditis diagnoses.

A 21-year-old male with no significant past medical history presented with myalgia, chills, mild headache, and chest pain for two days. Patient received the Moderna COVID-19 vaccine the day prior to symptom onset. On presentation, electrocardiogram (ECG) revealed sinus rhythm with ST elevation, and troponin was elevated. Emergent cardiac catheterization was not significant for abnormalities. The primary diagnosis was acute pericarditis, and the patient was discharged on colchicine and indomethacin. Additionally, a 35-year-old male with no pertinent past medical history presented with fever, chills, weakness, nausea, vomiting, diarrhea, and retrosternal chest pain for three days. He received the Moderna COVID-19 vaccine four days prior to symptom onset. On presentation, troponin was elevated, and ECG revealed mild ST elevation. Left ventricular dysfunction with ejection fraction of 41% was reported on transthoracic echocardiogram. Patient was started on ibuprofen and colchicine for diagnosis of myopericarditis.

These case reports highlight a potential unintended consequence, pericarditis, associated with COVID-19 vaccination that may not warrant invasive cardiac intervention.

• Pericarditis
• Myocarditis
• COVID-19
• COVID-19 vaccine
• Myopericarditis
• Case report

• COVID-19
• Echocardiography
• Myocardial strain
• Ultramobile devices

• COVID-19/diagnostic imaging
• Echocardiography
• Humans
• Pandemics
• SARS-CoV-2
• Technology

• Adverse events
• Brighton Collaboration
• Case definition
• Guidelines
• Immunization
• Myocarditis
• Myopericarditis
• Pericarditis

COVID 19, caused by SARS-CoV-2, is a highly infectious disease, mainly affects the respiratory system. In this article, we have presented a case of COVID-19, who presented solely with pericarditis without myocarditis, without any respiratory symptoms. The diagnosis was made based on clinical, electrocardiographic, radiological and biological findings. He was treated successfully with aspirin and colchicine. Our case highlights an atypical presentation of COVID-19, which should be kept in mind in the present pandemic and to diagnose and isolate early to limit the spread of infection.

• COVID-19
• Colchicine/therapeutic use
• Humans
• Male
• Pandemics
• Pericarditis/diagnosis
• Pericarditis/drug therapy
• SARS-CoV-2

• COVID-19
• Chronic disease
• Electrocardiography
• Heart
• Prognosis
• SARS-CoV-2

• COVID-19
• Electrocardiography
• Humans
• SARS-CoV-2

• Echocardiography
• Humans
• Mediastinal Cyst/complications
• Mediastinal Cyst/diagnosis
• Mediastinal Cyst/surgery
• Pericarditis/diagnosis
• Pericarditis/etiology

• COVID-19
• MACE
• cardiovascular sequelae
• myocarditis
• pericarditis

In this article we summarize suspected adverse events following immunization (AEFI) of pericarditis, myocarditis and perimyocarditis that were reported by our regional pharmacovigilance centre after COVID-19 mRNA-vaccination and discuss their association with these vaccines. Seventeen cases were reported between March and July 2021. Of these, nine had perimyocarditis, five myocarditis and three pericarditis. Twelve patients were male (71%). The median age was 38 years (range 17–88). The most commonly observed presenting symptom was acute chest pain (65%). While 47% of the patients were previously healthy, 53% had at least one pre-existing comorbidity, with hypertension being the most prevalent (24%). The European Society of Cardiology diagnostic criteria for the reported AEFIs were fulfilled in twelve cases (71%). The AEFIs occurred after the first vaccine dose in six cases (35%), after the second vaccine dose in ten cases (59%) and after both doses in one case (6%). The median latency of all AEFIs taken together was 14 days (range 1–28) after the first vaccination and 3 days (range 1–17) after the second one. All patients except one were hospitalized (94%) with a median length of stay of 7.5 days (range 3–13). The majority of patients (n = 11, 65%) did not experience any complications, and 13 (77%) of the patients had recovered or were recovering at the time of discharge. In 16 of the 17 cases (94%), the association between the AEFI and mRNA-vaccination was considered possible by the pharmacovigilance centre.

• Autoimmunity
• BNT162b2
• COVID-19
• SARS-CoV-2
• Vaccines

• Autoimmune Diseases/chemically induced
• BNT162 Vaccine
• COVID-19 Vaccines/adverse effects
• Humans
• Immunogenicity, Vaccine/immunology
• SARS-CoV-2

• COVID-19
• emergency department
• microbiota
• myocarditis

• Arrhythmia
• COVID-19
• Myocardial infarction
• Myocarditis
• Venous thrombosis

• ARDS
• Acute respiratory distress syndrome
• COVID-19
• Coronavirus disease 2019
• Exosomes
• Extracellular vesicles
• MSCs
• Mesenchymal stem cells
• Mesenchymal stromal cells
• Microvesicles
• Pneumonia
• SARS-CoV-2
• Sepsis
• Severe acute respiratory syndrome coronavirus 2

• COVID-19/complications
• COVID-19/epidemiology
• COVID-19/physiopathology
• COVID-19/therapy
• Case-Control Studies
• Female
• Humans
• Male
• Middle Aged
• Patient Care Management/methods
• Patient Care Management/statistics & numerical data
• Pericarditis/diagnosis
• Pericarditis/drug therapy
• Pericarditis/etiology
• Pericarditis/physiopathology
• Prognosis
• SARS-CoV-2/isolation & purification

• COVID-19
• SARS-CoV-2
• cytokine storm
• pericardial effusion
• pericarditis

• Artritis reumatoide
• Biological treatment
• COVID-19
• Pericarditis
• Rheumatoid arthritis
• Tratamiento biológico

• covid 19
• kidney transplant recipient
• remdesivir
• sars-cov-2
• viral pericarditis

We report the case of a previously healthy young woman, who developed a severe form of COVID-19 with massive pneumonia and acute pericarditis in whom constrictive physiology developed rapidly. To our knowledge, this represents the second reported case of SARS-CoV-2 constrictive pericarditis, a rare, but severe cardiac complication.

• COVID-19
• pericardial disease

• COVID19
• Myocarditis
• Pericardial disease
• Pericardial effusion
• Pericardial tamponade
• Pericarditis

This report documents a rare case of COVID-19-associated constrictive pericarditis (CP) in the setting of a recent COVID-19 infection. A 55-year-old man with a history of hypertension and gout presented with acute hypoxic respiratory failure and was diagnosed with COVID-19 pneumonia with progression to acute respiratory distress syndrome. His hospital course was complicated by a large pericardial effusion; an emergent bedside transthoracic echocardiography was concerning for cardiac tamponade, so pericardiocentesis was performed. A workup with cardiac magnetic resonance imaging showed changes consistent with a diagnosis of CP. Viral and idiopathic aetiologies are the most common cause of CP in the developed world, with COVID-19 now a proposed predisposing viral illness. The virus induces systemic inflammation and pericardial changes that can lead to CP physiology. Imaging modalities including echocardiogram and cardiac magnetic resonance play an integral role in confirming the diagnosis.

• COVID-19
• cardiovascular medicine
• cardiovascular system
• infectious diseases
• pericardial disease

The COVID-19 is a global pandemic that is now responsible for more than 2 million deaths around the world. Its clinical manifestations are well known such as fever, fatigue and other respiratory signs like severe cough, dyspnea. Cardiac involvement, however, is less recognized and often underestimated and could be the only manifestation of COVID-19. Case presentation: We report a case of pericarditis as the primary presentation of COVID-19 among a young, healthy individual with no medical background, in the absence of the conventional respiratory signs. The diagnosis was based on a set of clinical, biological, radiological and electrocardiographic findings. In this case, the treatment was based on the use of Colchicine in addition to COVID-19 treatment. The outcome was favorable; noticing regression of symptoms and disappearance of pericardial effusion within two weeks. Clinical discussion: Acute pericarditis has been widely described in literature as probable complication of COVID-19, yet only few articles have reported it as a primary manifestation of COVID-19. Conclusion: Chest pain could be the only presenting symptom of COVID-19 among young, healthy individuals.To that end, clinicians should recognize cardiac involvement of COVID-19 and act accordingly to isolate patients and further limit the spread of the disease.

•

The covid-19 is a global pandemic that is responsible for millions of deaths.

• Acute pericarditis
• COVID 19
• Colchicine
• Pericardial effusion

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus identified after widespread pneumonia cases in Wuhan, China at the end of 2019. This virus has been deemed a global pandemic and there remain many unknowns regarding the pathogenesis, management, treatment, and outcomes. This case report highlights a rare condition that possibly developed from the novel virus. 

A 68-year-old Hispanic male with hypertension and gastroesophageal reflux disease, presented with two weeks history of fevers, chills, cough, and progressive shortness of breath. He was found to be positive for the novel SARS-CoV-2 upon admission. He rapidly developed severe acute respiratory distress syndrome (ARDS) secondary to his coronavirus disease 2019 (COVID-19) pneumonia requiring intubation and full ventilator support associated with acute anuric renal failure requiring emergent hemodialysis catheter placement and continuous renal replacement therapy (CRRT). Two weeks after being on mechanical ventilation and CRRT, he developed episodes of hypotension and tachycardia. A chest radiograph and computed tomography (CT) scan diagnosed pneumopericardium.

In the case presented, the patient’s CT of his thorax demonstrated bilateral ground-glass opacities and bilateral reticulations consistent with intraparenchymal injuries, most likely from his ARDS secondary to his initial SARS-CoV-2 infection. To date, there remains an unknown association between COVID-19 and causation of pneumomediastinum and pneumopericardium. There continues to be reports of clinically significant findings of pneumomediastinum and pneumopericardium in COVID-19 patients. It is known that COVID-19 causes dysregulated inflammation leading to diffuse alveolar damage and rupture, as well as myocarditis which may be the precipitant to the development of pneumomediastinum and pneumopericardium.

This case highlights the findings of pneumopericardium and pneumomediastinum in the novel SARS-CoV-2 virus. Given the multiple reported cases with similar time frames to the development of spontaneous pneumomediastinum in COVID-19 patients, an association between COVID-19 and spontaneous pneumomediastinum should be further studied.

• covid-19
• pneumomediastinum
• pneumopericardium
• pulmonary critical care
• thoracic radiology