COVID-19-associated pericarditis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Main|COVID-19}}
{{SI}}
{{Main article|COVID-19}}
'''For COVID-19 frequently asked inpatient questions, click [[COVID-19 frequently asked inpatient questions|here]]'''<br>
'''For COVID-19 frequently asked inpatient questions, click [[COVID-19 frequently asked inpatient questions|here]]'''<br>
'''For COVID-19 frequently asked outpatient questions, click [[COVID-19 frequently asked outpatient questions|here]]'''<br>
'''For COVID-19 frequently asked outpatient questions, click [[COVID-19 frequently asked outpatient questions|here]]'''<br>'''For COVID-19 patient information, click [[COVID-19 (patient information)|here]]'''
{{SI}}


{{CMG}}; {{AE}}{{MRV}}
{{CMG}}; {{AE}} {{Sara.Zand}} {{MRV}}


{{SK}} Novel coronavirus, COVID-19, Wuhan Coronavirus, Coronavirus Disease-19, Coronavirus Disease 2019, SARS-CoV-2, COVID-19, COVID-19, 2019-nCoV, 2019 novel coronavirus, Cardiovascular finding in COVID-19, Myocardial injury in COVID-19, Myocarditis, Myocarditis in COVID-19, COVID-19-associated Myocarditis, SARS-CoV2-associated Myocarditis, Myocardial injury in COVID-19, COVID-19 myocarditis
{{SK}} Novel coronavirus, COVID-19, Wuhan coronavirus, coronavirus Disease-19, coronavirus disease 2019, SARS-CoV-2, COVID-19, COVID-19, 2019-nCoV, 2019 novel coronavirus, cardiovascular finding in COVID-19, pericardial injury in COVID-19, pericarditis, pericarditis in COVID-19, COVID-19-associated Pericarditis, SARS-CoV2-associated pericarditis, myocardial injury in COVID-19, COVID-19 pericarditis
==Overview==
==Overview==
[[COVID-19]] is caused by the [[novel coronavirus]], also known as [[SARS-CoV-2]]. It mainly affects the lungs, causing [[severe acute respiratory syndrome]]. It invades through the [[Angiotensin-converting enzyme 2]] (ACE2) receptors present abundantly not only in the [[lungs]] but also in the [[heart]], [[kidneys]], [[intestine]], [[brain]], [[skin]] thus causing [[multiorgan dysfunction]]. Studies have demonstrated that [[COVID-19]] interacts with the [[cardiovascular system]], thereby causing [[myocardial injury]] and dysfunction as well as increasing [[morbidity]] among patients with underlying cardiovascular conditions.
[[COVID-19]] caused by the [[novel coronavirus]], also known as [[SARS-CoV-2]] mainly affects the [[lungs]], causing [[severe acute respiratory syndrome]]. It has been proposed that [[covid-19]]  invades through the [[angiotensin-converting enzyme 2]] ([[ACE2]]) receptors present abundantly not only in the [[lungs]] but also in the [[heart]], [[endothelium]], [[cardiomyocyte]]s, [[epicardial adipose tissue]] adjacent to the visceral [[pericardium]].In addition, [[Inflammatory cascade ]] may prompt to [[cardiac]] manifestations in [[covid-19]]. [[ Acute pericarditis]] is one of the [[cardiac]] complications of [[covid-19]] resulting  from the [[inflammation]] of [[pericardial sac]] surrounding the [[heart]]. Few cases of [[covid-19]]-associated [[pericarditis]] have been reported whether none of them were proven to be  due to direct invasion of [[pericardium]] by [[corona virus]]. Reports on large [[pericardial effusion]] and [[cardiac]] [[tamponade]] are rare in [[covid-19]]. [[Pericarditis]] after [[vaccination]] of [[covid-19]] has been reported with few incidence in [[elderly]] [[patients]].


==Historical Perspective==
==Historical Perspective==
*The [[novel coronavirus]], [[SARS-CoV-2]], is identified as the cause of an outbreak of [[respiratory illness]] first detected in [[Wuhan]], [[China]] in late December 2019. [[SARS-CoV-2]] has rapidly spread across China and in other countries, raising major global concerns. This [[novel coronavirus]], [[SARS-CoV-2]], was named  the [[severe acute respiratory syndrome coronavirus-2]] [[(SARS-CoV-2)]] for it similarity [[severe acute respiratory syndrome related coronaviruses]] such as [[SARS-CoV]], which caused [[acute respiratory distress syndrome]] ([[ARDS]]) in 2002–2003.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/index.html|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name="LuCui2020">{{cite journal|last1=Lu|first1=Jian|last2=Cui|first2=Jie|last3=Qian|first3=Zhaohui|last4=Wang|first4=Yirong|last5=Zhang|first5=Hong|last6=Duan|first6=Yuange|last7=Wu|first7=Xinkai|last8=Yao|first8=Xinmin|last9=Song|first9=Yuhe|last10=Li|first10=Xiang|last11=Wu|first11=Changcheng|last12=Tang|first12=Xiaolu|title=On the origin and continuing evolution of SARS-CoV-2|journal=National Science Review|year=2020|issn=2095-5138|doi=10.1093/nsr/nwaa036}}</ref><ref name="HuangWang2020">{{cite journal|last1=Huang|first1=Chaolin|last2=Wang|first2=Yeming|last3=Li|first3=Xingwang|last4=Ren|first4=Lili|last5=Zhao|first5=Jianping|last6=Hu|first6=Yi|last7=Zhang|first7=Li|last8=Fan|first8=Guohui|last9=Xu|first9=Jiuyang|last10=Gu|first10=Xiaoying|last11=Cheng|first11=Zhenshun|last12=Yu|first12=Ting|last13=Xia|first13=Jiaan|last14=Wei|first14=Yuan|last15=Wu|first15=Wenjuan|last16=Xie|first16=Xuelei|last17=Yin|first17=Wen|last18=Li|first18=Hui|last19=Liu|first19=Min|last20=Xiao|first20=Yan|last21=Gao|first21=Hong|last22=Guo|first22=Li|last23=Xie|first23=Jungang|last24=Wang|first24=Guangfa|last25=Jiang|first25=Rongmeng|last26=Gao|first26=Zhancheng|last27=Jin|first27=Qi|last28=Wang|first28=Jianwei|last29=Cao|first29=Bin|title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China|journal=The Lancet|volume=395|issue=10223|year=2020|pages=497–506|issn=01406736|doi=10.1016/S0140-6736(20)30183-5}}</ref><ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref>{{cite web |url=https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ |title=WHO &#124; Novel Coronavirus – China |format= |work= |accessdate=}}</ref>
 
*On January 30, 2020,the [[World Health Organization]]([[WHO]]) declared the outbreak as a [[Public Health Emergency]] of International Concern.<ref>{{cite web |url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen |title=Coronavirus (COVID-19) events as they happen |format= |work= |accessdate=}}</ref>
 
* [[Acute pericarditis]] associated with [[covid-19]]  was first reported by Yale Tung-Chen in 2020 during investigation about worsening of [[pleuritic chest pain]] in a young [[covid-19]] [[patient]] and [[finding]] of mild [[pericardial effusion]] by [[cardiac]] [[sonography]].<ref name="pmid32835093">{{cite journal |vauthors=Tung-Chen Y |title=Acute pericarditis due to COVID-19 infection: An underdiagnosed disease? |journal=Med Clin (Engl Ed) |volume=155 |issue=1 |pages=44–45 |date=July 2020 |pmid=32835093 |pmc=7333598 |doi=10.1016/j.medcle.2020.06.001 |url=}}</ref>
 
*The [[novel coronavirus]], [[SARS-CoV-2]], is identified as the cause of an [[outbreak]] of [[respiratory illness]] first detected in [[Wuhan]], [[China]] in late December 2019. [[SARS-CoV-2]] has rapidly spread across China and in other countries, raising major global concerns.  
*This [[novel coronavirus]], [[SARS-CoV-2]], was named  the [[severe acute respiratory syndrome]] coronavirus-2 ([[SARS-CoV-2]]) for it similarity [[severe acute respiratory syndrome]] related [[coronaviruses]] such as [[SARS-CoV]], which caused [[acute respiratory distress syndrome]] ([[ARDS]]) in 2002–2003.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/index.html|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name="LuCui2020">{{cite journal|last1=Lu|first1=Jian|last2=Cui|first2=Jie|last3=Qian|first3=Zhaohui|last4=Wang|first4=Yirong|last5=Zhang|first5=Hong|last6=Duan|first6=Yuange|last7=Wu|first7=Xinkai|last8=Yao|first8=Xinmin|last9=Song|first9=Yuhe|last10=Li|first10=Xiang|last11=Wu|first11=Changcheng|last12=Tang|first12=Xiaolu|title=On the origin and continuing evolution of SARS-CoV-2|journal=National Science Review|year=2020|issn=2095-5138|doi=10.1093/nsr/nwaa036}}</ref><ref name="HuangWang2020">{{cite journal|last1=Huang|first1=Chaolin|last2=Wang|first2=Yeming|last3=Li|first3=Xingwang|last4=Ren|first4=Lili|last5=Zhao|first5=Jianping|last6=Hu|first6=Yi|last7=Zhang|first7=Li|last8=Fan|first8=Guohui|last9=Xu|first9=Jiuyang|last10=Gu|first10=Xiaoying|last11=Cheng|first11=Zhenshun|last12=Yu|first12=Ting|last13=Xia|first13=Jiaan|last14=Wei|first14=Yuan|last15=Wu|first15=Wenjuan|last16=Xie|first16=Xuelei|last17=Yin|first17=Wen|last18=Li|first18=Hui|last19=Liu|first19=Min|last20=Xiao|first20=Yan|last21=Gao|first21=Hong|last22=Guo|first22=Li|last23=Xie|first23=Jungang|last24=Wang|first24=Guangfa|last25=Jiang|first25=Rongmeng|last26=Gao|first26=Zhancheng|last27=Jin|first27=Qi|last28=Wang|first28=Jianwei|last29=Cao|first29=Bin|title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China|journal=The Lancet|volume=395|issue=10223|year=2020|pages=497–506|issn=01406736|doi=10.1016/S0140-6736(20)30183-5}}</ref><ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref>{{cite web |url=https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ |title=WHO &#124; Novel Coronavirus – China |format= |work= |accessdate=}}</ref>
*On January 30, 2020, the [[World Health Organization]] ([[WHO]]) declared the outbreak a Public Health Emergency of International Concern.<ref>{{cite web |url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen |title=Coronavirus (COVID-19) events as they happen |format= |work= |accessdate=}}</ref>
*On March 12, 2020, the [[World Health Organization]] declared the [[COVID-19]] outbreak a [[pandemic]].<ref>{{cite web |url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen |title=Coronavirus (COVID-19) events as they happen |format= |work= |accessdate=}}</ref>
*On March 12, 2020, the [[World Health Organization]] declared the [[COVID-19]] outbreak a [[pandemic]].<ref>{{cite web |url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen |title=Coronavirus (COVID-19) events as they happen |format= |work= |accessdate=}}</ref>


==Classification==
==Classification==
*There is no established system for the classification of the [[pericarditis]] seen in [[COVID-19]].
*There is no established system for the classification of the [[pericarditis]] seen in [[COVID-19]].
*For more information regarding general classification, see the [[pericarditis classification]].
*For general classification of [[pericarditis]], [[pericarditis classification|click here]].
   
   
==Pathophysiology==
==Pathophysiology==
*The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
*[[Viral]] [[infections]] are a common cause of [[pericarditis]].
*The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
* It is hypothesized that [[virus]]es cause [[pericardial]] [[inflammation]] via direct [[cytotoxic]] effects or via [[immune]]-mediated mechanisms.<ref name="TomkowskiSwedberg2015">{{cite journal|last1=Tomkowski|first1=Witold|last2=Swedberg|first2=Karl|last3=Seferovic|first3=Petar|last4=Sabaté Tenas|first4=Manel|last5=Ristić|first5=Arsen D|last6=Pavie|first6=Alain|last7=Mayosi|first7=Bongani|last8=Maisch|first8=Bernhard|last9=Lionis|first9=Christos|last10=Klingel|first10=Karin|last11=Gueret|first11=Pascal|last12=Brucato|first12=Antonio|last13=Bogaert|first13=Jan|last14=Barón-Esquivias|first14=Gonzalo|last15=Badano|first15=Luigi|last16=Imazio|first16=Massimo|last17=Charron|first17=Philippe|last18=Adler|first18=Yehuda|last19=Achenbach|first19=Stephan|last20=Agewall|first20=Stefan|last21=Al-Attar|first21=Nawwar|last22=Angel Ferrer|first22=Juan|last23=Arad|first23=Michael|last24=Asteggiano|first24=Riccardo|last25=Bueno|first25=Héctor|last26=Caforio|first26=Alida L P|last27=Carerj|first27=Scipione|last28=Ceconi|first28=Claudio|last29=Evangelista|first29=Arturo|last30=Flachskampf|first30=Frank|last31=Giannakoulas|first31=George|last32=Gielen|first32=Stephan|last33=Habib|first33=Gilbert|last34=Kolh|first34=Philippe|last35=Lambrinou|first35=Ekaterini|last36=Lancellotti|first36=Patrizio|last37=Lazaros|first37=George|last38=Linhart|first38=Ales|last39=Meurin|first39=Philippe|last40=Nieman|first40=Koen|last41=Piepoli|first41=Massimo F|last42=Price|first42=Susanna|last43=Roos-Hesselink|first43=Jolien|last44=Roubille|first44=François|last45=Ruschitzka|first45=Frank|last46=Sagristà Sauleda|first46=Jaume|last47=Sousa-Uva|first47=Miguel|last48=Uwe Voigt|first48=Jens|last49=Luis Zamorano|first49=Jose|last50=Zamorano|first50=Jose Luis|last51=Aboyans|first51=Victor|last52=Achenbach|first52=Stephan|last53=Agewall|first53=Stefan|last54=Badimon|first54=Lina|last55=Barón-Esquivias|first55=Gonzalo|last56=Baumgartner|first56=Helmut|last57=Bax|first57=Jeroen J|last58=Bueno|first58=Héctor|last59=Carerj|first59=Scipione|last60=Dean|first60=Veronica|last61=Erol|first61=Çetin|last62=Fitzimons|first62=Donna|last63=Gaemperli|first63=Oliver|last64=Kirchhof|first64=Paulus|last65=Kolh|first65=Philippe|last66=Lancellotti|first66=Patrizio|last67=Lip|first67=Gregory YH|last68=Nihoyannopoulos|first68=Petros|last69=Piepoli|first69=Massimo F|last70=Ponikowski|first70=Piotr|last71=Roffi|first71=Marco|last72=Torbicki|first72=Adam|last73=Vaz Carneiro|first73=Antonio|last74=Windecker|first74=Stephan|last75=Shuka|first75=Naltin|last76=Sisakian|first76=Hamayak|last77=Mascherbauer|first77=Julia|last78=Isayev|first78=Elnur|last79=Shumavets|first79=Vadim|last80=Van Camp|first80=Guy|last81=Gatzov|first81=Plamen|last82=Hanzevacki|first82=Jadranka Separovic|last83=Moustra|first83=Hera Heracleous|last84=Linhart|first84=Ales|last85=Møller|first85=Jacob Eifer|last86=Aboleineen|first86=Mohamed Wafaie|last87=Põder|first87=Pentti|last88=Lehtonen|first88=Jukka|last89=Antov|first89=Slobodan|last90=Damy|first90=Thibaud|last91=Schieffer|first91=Bernhard|last92=Dimitriadis|first92=Kyriakos|last93=Kiss|first93=Robert Gabor|last94=Rafnsson|first94=Arnar|last95=Arad|first95=Michael|last96=Novo|first96=Salvatore|last97=Mirrakhimov|first97=Erkin|last98=Stradinš|first98=Peteris|last99=Kavoliuniene|first99=Ausra|last100=Codreanu|first100=Andrei|last101=Dingli |first101=Philip|last102=Vataman|first102=Eleonora|last103=El Hattaoui|first103=Mustapaha|last104=Samstad|first104=Stein Olav|last105=Hoffman|first105=Piotr|last106=Lopes|first106=Luís Rocha|last107=Dimulescu|first107=Doina Ruxandra|last108=Arutyunov|first108=Grigory P|last109=Pavlovic|first109=Milan|last110=Dúbrava|first110=Juraj|last111=Sauleda|first111=Jaume Sagristà|last112=Andersson|first112=Bert|last113=Müller|first113=Hajo|last114=Bouma|first114=Berto J|last115=Abaci|first115=Adnan|last116=Archbold|first116=Andrew|last117=Nesukay|first117=Elena|title=2015 ESC Guidelines for the diagnosis and management of pericardial diseases|journal=European Heart Journal|volume=36|issue=42|year=2015|pages=2921–2964|issn=0195-668X|doi=10.1093/eurheartj/ehv318}}</ref>
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*The exact mechanism of [[covid-19]] induced [[pericarditis]] is not yet well known.
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*Probable mechanisms of [[covid-19]]-associated [[pericarditis]] from the limited cases reported are:
**Direct [[invasion]] of the [[virus]]
**[[Cytokine storm]] and systemic [[hyperinflammatory]] response: This might be leading to [[pericarditis]] and subsequent [[pericardial effusion]] in certain [[patients]].
* [[Pericardial biopsy]] of a [[covid-19]] [[patients]] showed reactive [[mesothelial cell]]s, [[lymphocytes]], [[macrophages]].<ref name="pmid32925751">{{cite journal |vauthors=Amoozgar B, Kaushal V, Mubashar U, Sen S, Yousaf S, Yotsuya M |title=Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection: A case report |journal=Medicine (Baltimore) |volume=99 |issue=37 |pages=e22093 |date=September 2020 |pmid=32925751 |pmc=7489591 |doi=10.1097/MD.0000000000022093 |url=}}</ref>
* Increased level of [[cytokines]] including IL1, TNF-alpha as well as activated inflammatory cascade are noted in the [[pathogenesis]] of [[pericarditis]] in [[covid-19]].<ref name="pmid32968776">{{cite journal |vauthors=Basso C, Leone O, Rizzo S, De Gaspari M, van der Wal AC, Aubry MC, Bois MC, Lin PT, Maleszewski JJ, Stone JR |title=Pathological features of COVID-19-associated myocardial injury: a multicentre cardiovascular pathology study |journal=Eur Heart J |volume=41 |issue=39 |pages=3827–3835 |date=October 2020 |pmid=32968776 |pmc=7543528 |doi=10.1093/eurheartj/ehaa664 |url=}}</ref>
* Postmortem [[histopatholigical]] analysis of [[heart]] in [[covid-19]] [[patients]]  demonstrated infiltration of [[CD8]] [[lymphocytes]] and [[lymphocytes]] [[proliferation]] in [[pericardium]].<ref name="pmid32968776">{{cite journal |vauthors=Basso C, Leone O, Rizzo S, De Gaspari M, van der Wal AC, Aubry MC, Bois MC, Lin PT, Maleszewski JJ, Stone JR |title=Pathological features of COVID-19-associated myocardial injury: a multicentre cardiovascular pathology study |journal=Eur Heart J |volume=41 |issue=39 |pages=3827–3835 |date=October 2020 |pmid=32968776 |pmc=7543528 |doi=10.1093/eurheartj/ehaa664 |url=}}</ref>
*[[SARS-COV-2]] can attach to [[ACE2]] receptos presented in the [[endothelium]], [[cardiomyocytes]], [[epicardial adipose tissue]], adjacent to the [[pericardium]]. However, the exact mechanism of direct [[viruse]] damage to [[cardiac]] structure requires further investigation.<ref name="pmid32208485">{{cite journal |vauthors=Patel AB, Verma A |title=COVID-19 and Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: What Is the Evidence? |journal=JAMA |volume=323 |issue=18 |pages=1769–1770 |date=May 2020 |pmid=32208485 |doi=10.1001/jama.2020.4812 |url=}}</ref>


==Clinical Features==
==Causes==
[[Pericarditis]] in [[COVID-19]] is likely caused by:
*Direct [[invasion]] by [[SARS-CoV-2]]
*Pro-[[inflammatory]] [[cytokine storm]]
 
==Differentiating COVID-19-associated pericarditis from other diseases==
*For further information about the differential diagnosis, click [[Differentiating COVID-19-associated pericarditis from other diseases|here]].
*For further information about the differential diagnosis of [[COVID-19]], click [[COVID-19 differential diagnosis|here]].


==Differentiating [disease name] from other Diseases==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
:*[Differential dx1]
:*[Differential dx2]
:*[Differential dx3]
==Epidemiology and Demographics==
==Epidemiology and Demographics==
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
*[[Pericarditis]] is a rare manifestation of [[covid-19]].<ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref><ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref><ref name="MaceiraLopez-Lereu2020">{{cite journal|last1=Maceira|first1=Alicia M|last2=Lopez-Lereu|first2=Maria P|last3=Higueras Ortega|first3=Laura|last4=García-Gonzalez|first4=Pilar|last5=Broseta Torres|first5=Ricardo|last6=Solsona Caravaca|first6=Javier|last7=Ventura Perez|first7=Bruno|last8=Andres Soler|first8=Jorge|last9=Dominguez Mafe|first9=Eloy|last10=Monmeneu|first10=Jose V|last11=Voges|first11=Inga|title=Subacute perimyocarditis in a young patient with COVID-19 infection|journal=European Heart Journal - Case Reports|year=2020|issn=2514-2119|doi=10.1093/ehjcr/ytaa157}}</ref><ref name="ByrneSado2020">{{cite journal|last1=Byrne|first1=Jonathan|last2=Sado|first2=Daniel|last3=O’Gallagher|first3=Kevin|last4=Hua|first4=Alina|title=Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19|journal=European Heart Journal|volume=41|issue=22|year=2020|pages=2130–2130|issn=0195-668X|doi=10.1093/eurheartj/ehaa253}}</ref><ref name="CizgiciZencirkiran Agus2020">{{cite journal|last1=Cizgici|first1=Ahmet Yasar|last2=Zencirkiran Agus|first2=Hicaz|last3=Yildiz|first3=Mustafa|title=COVID-19 myopericarditis: It should be kept in mind in today's conditions|journal=The American Journal of Emergency Medicine|volume=38|issue=7|year=2020|pages=1547.e5–1547.e6|issn=07356757|doi=10.1016/j.ajem.2020.04.080}}</ref><ref name="Tung-Chen2020">{{cite journal|last1=Tung-Chen|first1=Yale|title=Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?|journal=Medicina Clínica|volume=155|issue=1|year=2020|pages=44–45|issn=00257753|doi=10.1016/j.medcli.2020.04.007}}</ref><ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref>
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
*There is currently no available data on the [[incidence]] of [[pericarditis]] in [[covid-19]] [[patients]]. However, the [[incidence]] of [[pericarditis]] in [[covid-19]] [[patients]] was higher than general [[population]] without [[covid-19]].<ref name="pmid32843127">{{cite journal |vauthors=Miró Ò, Llorens P, Jiménez S, Piñera P, Burillo-Putze G, Martín A, Martín-Sánchez FJ, González Del Castillo J |title=Frequency of five unusual presentations in patients with COVID-19: results of the UMC-19-S1 |journal=Epidemiol Infect |volume=148 |issue= |pages=e189 |date=August 2020 |pmid=32843127 |pmc=7477462 |doi=10.1017/S0950268820001910 |url=}}</ref>
*Post-mortem studies have shown [[pericarditis]] was approximately in 20% of [[covid-19]] [[cases]].<ref name="pmid32844161">{{cite journal |vauthors=Hanley B, Naresh KN, Roufosse C, Nicholson AG, Weir J, Cooke GS, Thursz M, Manousou P, Corbett R, Goldin R, Al-Sarraj S, Abdolrasouli A, Swann OC, Baillon L, Penn R, Barclay WS, Viola P, Osborn M |title=Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study |journal=Lancet Microbe |volume=1 |issue=6 |pages=e245–e253 |date=October 2020 |pmid=32844161 |pmc=7440861 |doi=10.1016/S2666-5247(20)30115-4 |url=}}</ref>
 
===Age===
===Age===
*Patients of all age groups may develop [disease name].
*There is no data on age predilection to [[pericarditis]] in [[COVID-19]].
* [[Pericarditis]] after vaccination of [[COVID-19]] was commonly observed in elderly [[patients]].<ref name="pmid34347001">{{cite journal |vauthors=Diaz GA, Parsons GT, Gering SK, Meier AR, Hutchinson IV, Robicsek A |title=Myocarditis and Pericarditis After Vaccination for COVID-19 |journal=JAMA |volume=326 |issue=12 |pages=1210–1212 |date=September 2021 |pmid=34347001 |doi=10.1001/jama.2021.13443 |url=}}</ref>
*[Disease name] is more commonly observed among patients aged [age range] years old.
 
*[Disease name] is more commonly observed among [elderly patients/young patients/children].
===Gender===
===Gender===
*[Disease name] affects men and women equally.
*There is no data on gender predilection to [[pericarditis]] in [[covid-19]].
*The number of cases in [[females]] are more than [[males]] among the few cases reported.
*[Gender 1] are more commonly affected with [disease name] than [gender 2].
 
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
===Race===
===Race===
*There is no racial predilection for [disease name].
*There is no data on racial predilection to [[pericarditis]] in [[covid-19]].
 
*[Disease name] usually affects individuals of the [race 1] race.
== Natural History, Complications and Prognosis==
*[Race 2] individuals are less likely to develop [disease name].
 


==Risk Factors==
* Pericardial involvement is an uncommon manifestation of [[covid-19]] and requires high clinical suspicion for diagnosis and treatment.
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
* Early clinical features of involving [[pericardium]] include [[retrosternal]] [[chest pain]], [[diffuse upward sloping ST segments]], [[pericardial effusion]] in [[echocardiography]].
*If left untreated, [[acute pericarditis]] may progress to develop [[cardiac tamponade]], [[chronic constrictive pericarditis]], [[chronic effusive pericarditis]].<ref name="pmid26567493">{{cite journal |vauthors=Kloos JA |title=Characteristics, Complications, and Treatment of Acute Pericarditis |journal=Crit Care Nurs Clin North Am |volume=27 |issue=4 |pages=483–97 |date=December 2015 |pmid=26567493 |doi=10.1016/j.cnc.2015.08.001 |url=}}</ref>
* Reported complications of [[pericarditis]] related to [[covid-19]] in literature are:
*: [[Tamponade]]<ref name="pmid32227076">{{cite journal |vauthors=Hua A, O'Gallagher K, Sado D, Byrne J |title=Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19 |journal=Eur Heart J |volume=41 |issue=22 |pages=2130 |date=June 2020 |pmid=32227076 |pmc=7184427 |doi=10.1093/eurheartj/ehaa253 |url=}}</ref>
*: Large hemorrhagic [[pericardial effusion]]<ref name="pmid32328588">{{cite journal |vauthors=Dabbagh MF, Aurora L, D'Souza P, Weinmann AJ, Bhargava P, Basir MB |title=Cardiac Tamponade Secondary to COVID-19 |journal=JACC Case Rep |volume=2 |issue=9 |pages=1326–1330 |date=July 2020 |pmid=32328588 |pmc=7177077 |doi=10.1016/j.jaccas.2020.04.009 |url=}}</ref>
*: Acute effusive [[pericarditis]] <ref name="pmid32656050">{{cite journal |vauthors=Fox K, Prokup JA, Butson K, Jordan K |title=Acute Effusive Pericarditis: A Late Complication of COVID-19 |journal=Cureus |volume=12 |issue=7 |pages=e9074 |date=July 2020 |pmid=32656050 |pmc=7348211 |doi=10.7759/cureus.9074 |url=}}</ref>
*: Acute [[myopericarditis]] <ref name="pmid32360119">{{cite journal |vauthors=Cizgici AY, Zencirkiran Agus H, Yildiz M |title=COVID-19 myopericarditis: It should be kept in mind in today's conditions |journal=Am J Emerg Med |volume=38 |issue=7 |pages=1547.e5–1547.e6 |date=July 2020 |pmid=32360119 |pmc=7187845 |doi=10.1016/j.ajem.2020.04.080 |url=}}</ref>


== Natural History, Complications and Prognosis==
* Prognosis is generally good. However, the presence of large [[pericardial effusion]], [[tamponade]], [[myopericarditis]], high [[CRP]], NO response to [[colchicine]] make the prognosis worse.<ref name="pmid27884251">{{cite journal |vauthors=Cremer PC, Kumar A, Kontzias A, Tan CD, Rodriguez ER, Imazio M, Klein AL |title=Complicated Pericarditis: Understanding Risk Factors and Pathophysiology to Inform Imaging and Treatment |journal=J Am Coll Cardiol |volume=68 |issue=21 |pages=2311–2328 |date=November 2016 |pmid=27884251 |doi=10.1016/j.jacc.2016.07.785 |url=}}</ref>
*The majority of patients with [disease name] remain asymptomatic for [duration/years].
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].


== Diagnosis ==
== Diagnosis ==
===Diagnostic Criteria===
* High clinical suspicion is necessary to identify the involvement of [[pericardial layer]] in [[covid-19]] [[patients]].
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
* In the suspicion of acute [[pericarditis]], obtaining an [[ECG]], [[blood test sampling]] of [[inflammatory]] and [[myocardial injury]] parameters and [[transthoracic echocardiography]] are recommended.<ref name="pmid27884251">{{cite journal |vauthors=Cremer PC, Kumar A, Kontzias A, Tan CD, Rodriguez ER, Imazio M, Klein AL |title=Complicated Pericarditis: Understanding Risk Factors and Pathophysiology to Inform Imaging and Treatment |journal=J Am Coll Cardiol |volume=68 |issue=21 |pages=2311–2328 |date=November 2016 |pmid=27884251 |doi=10.1016/j.jacc.2016.07.785 |url=}}</ref>
:*[criterion 1]
:*[criterion 2]
:*[criterion 3]
:*[criterion 4]
=== Symptoms ===
=== Symptoms ===
*[Disease name] is usually asymptomatic.
[[Symptom|Symptoms]] of [[pericarditis]] in [[COVID-19]] may include the following:
*Symptoms of [disease name] may include the following:
:*[[Fever]]
:*[symptom 1]
:*[[Chest pain]]
:*[symptom 2]
:*[[Dyspnea]]
:*[symptom 3]
:*[[Cough]]
:*[symptom 4]
:*[[Fatigue]]
:*[symptom 5]
:*[[Malaise]]
:*[symptom 6]
 
=== Physical Examination ===
=== Physical Examination ===
*Patients with [disease name] usually appear [general appearance].
[[Physical examination]] may be remarkable for:
*Physical examination may be remarkable for:
:*[[Fever]]
:*[finding 1]
:*[[Pericardial friction rub]]
:*[finding 2]
:*[[Tachycardia]], [[hypotension]] and distant [[heart sounds]] seen in [[cardiac tamponade]]
:*[finding 3]
:*[finding 4]
:*[finding 5]
:*[finding 6]


=== Laboratory Findings ===
=== Laboratory Findings ===
*There are no specific laboratory findings associated with [disease name].


*A  [positive/negative] [test name] is diagnostic of [disease name].
====Inflammatory biomarkers====
*An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
*Non-specific markers of [[inflammation]] are commonly elevated in [[pericarditis]].<ref>{{cite web |url=https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Diagnosis-of-acute-pericarditis |title=Diagnosis of acute pericarditis |format= |work= |accessdate=}}</ref> These include:
*Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
**[[Leukocyte]] count
**[[C-reactive protein]] ([[CRP]])
===Imaging Findings===
**[[Erythrocyte Sedimentation Rate]] ([[ESR]])
*There are no [imaging study] findings associated with [disease name].
 
*Elevated [[inflammatory]] markers, specifically [[WBC]] count and [[CRP]] was seen in [[COVID-19]]-associated [[pericarditis]] cases.<ref name="CizgiciZencirkiran Agus2020">{{cite journal|last1=Cizgici|first1=Ahmet Yasar|last2=Zencirkiran Agus|first2=Hicaz|last3=Yildiz|first3=Mustafa|title=COVID-19 myopericarditis: It should be kept in mind in today's conditions|journal=The American Journal of Emergency Medicine|volume=38|issue=7|year=2020|pages=1547.e5–1547.e6|issn=07356757|doi=10.1016/j.ajem.2020.04.080}}</ref><ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref><ref name="Tung-Chen2020">{{cite journal|last1=Tung-Chen|first1=Yale|title=Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?|journal=Medicina Clínica|volume=155|issue=1|year=2020|pages=44–45|issn=00257753|doi=10.1016/j.medcli.2020.04.007}}</ref><ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref>
*[Imaging study 1] is the imaging modality of choice for [disease name].
 
*On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
====Cardiac biomarkers====
*[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
*In the presence of concomitant [[myocarditis]] and [[pericarditis]] ([[myopericarditis]]), [[serum biomarkers]] of [[myocardial injury]], are elevated.<ref>{{cite web |url=https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Diagnosis-of-acute-pericarditis |title=Diagnosis of acute pericarditis |format= |work= |accessdate=}}</ref><ref name="ImazioDemichelis2003">{{cite journal|last1=Imazio|first1=Massimo|last2=Demichelis|first2=Brunella|last3=Cecchi|first3=Enrico|last4=Belli|first4=Riccardo|last5=Ghisio|first5=Aldo|last6=Bobbio|first6=Marco|last7=Trinchero|first7=Rita|title=Cardiac troponin i in acute pericarditis|journal=Journal of the American College of Cardiology|volume=42|issue=12|year=2003|pages=2144–2148|issn=07351097|doi=10.1016/j.jacc.2003.02.001}}</ref><ref name="Bonnefoy2000">{{cite journal|last1=Bonnefoy|first1=E|title=Serum cardiac troponin I and ST-segment elevation in patients with acute pericarditis|journal=European Heart Journal|volume=21|issue=10|year=2000|pages=832–836|issn=0195668X|doi=10.1053/euhj.1999.1907}}</ref> These include:
**[[Creatine Kinase]] ([[CK]])
=== Other Diagnostic Studies ===
**[[Cardiac troponin]] I or T
*[Disease name] may also be diagnosed using [diagnostic study name].
**Serum [[LDH]]
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
 
*Elevated [[cardiac markers]] was seen in [[COVID-19]]-associated [[pericarditis]] cases.<ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref><ref name="CizgiciZencirkiran Agus2020">{{cite journal|last1=Cizgici|first1=Ahmet Yasar|last2=Zencirkiran Agus|first2=Hicaz|last3=Yildiz|first3=Mustafa|title=COVID-19 myopericarditis: It should be kept in mind in today's conditions|journal=The American Journal of Emergency Medicine|volume=38|issue=7|year=2020|pages=1547.e5–1547.e6|issn=07356757|doi=10.1016/j.ajem.2020.04.080}}</ref><ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref><ref name="Tung-Chen2020">{{cite journal|last1=Tung-Chen|first1=Yale|title=Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?|journal=Medicina Clínica|volume=155|issue=1|year=2020|pages=44–45|issn=00257753|doi=10.1016/j.medcli.2020.04.007}}</ref><ref name="ByrneSado2020">{{cite journal|last1=Byrne|first1=Jonathan|last2=Sado|first2=Daniel|last3=O’Gallagher|first3=Kevin|last4=Hua|first4=Alina|title=Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19|journal=European Heart Journal|volume=41|issue=22|year=2020|pages=2130–2130|issn=0195-668X|doi=10.1093/eurheartj/ehaa253}}</ref>
 
===Electrocardiogram===
*[[Electrocardiogram]] ([[ECG]]) findings see in the reported cases of [[COVID-19]]-associated [[pericarditis]] include:
**[[ST elevation]] and [[PR depression]] are seen;<ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref><ref name="CizgiciZencirkiran Agus2020">{{cite journal|last1=Cizgici|first1=Ahmet Yasar|last2=Zencirkiran Agus|first2=Hicaz|last3=Yildiz|first3=Mustafa|title=COVID-19 myopericarditis: It should be kept in mind in today's conditions|journal=The American Journal of Emergency Medicine|volume=38|issue=7|year=2020|pages=1547.e5–1547.e6|issn=07356757|doi=10.1016/j.ajem.2020.04.080}}</ref><ref name="ByrneSado2020">{{cite journal|last1=Byrne|first1=Jonathan|last2=Sado|first2=Daniel|last3=O’Gallagher|first3=Kevin|last4=Hua|first4=Alina|title=Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19|journal=European Heart Journal|volume=41|issue=22|year=2020|pages=2130–2130|issn=0195-668X|doi=10.1093/eurheartj/ehaa253}}</ref> but these changes are not [[specificity|specific]] to [[COVID-19]] [[pericarditis]].
**Non-specific [[ST]] changes.<ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref>
**[[T wave inversion]] in the inferior leads (II, III and aVF).<ref name="Tung-Chen2020">{{cite journal|last1=Tung-Chen|first1=Yale|title=Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?|journal=Medicina Clínica|volume=155|issue=1|year=2020|pages=44–45|issn=00257753|doi=10.1016/j.medcli.2020.04.007}}</ref><ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref>
 
* For [[ECG]] changes in [[pericarditis]] in general, [[Pericarditis electrocardiogram|click here]].
 
===Imaging===
 
====Chest X-ray====
*[[Chest X-ray]] is usually within normal limits in [[acute pericarditis]].
*[[Chest x-ray]] demonstrated an [[enlarged cardiac silhouette]] in patients with [[COVID-19]] complicated by [[cardiac tamponade]].<ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref><ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref>
 
* For [[Chest X-ray]] findings in [[pericarditis]], [[Pericarditis x ray|click here]].
 
====Echocardiography====
*[[Echocardiography]] is the first-line test in the diagnosis of [[pericarditis]] and its complications.<ref>{{cite web |url=https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Diagnosis-of-acute-pericarditis |title=Diagnosis of acute pericarditis |format= |work= |accessdate=}}</ref>
*On imaging by [[echocardiography]] in the reported cases of [[COVID-19]]-associated [[pericarditis]], findings included:
**Small to moderate [[pericardial effusion]].<ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref><ref name="Tung-Chen2020">{{cite journal|last1=Tung-Chen|first1=Yale|title=Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?|journal=Medicina Clínica|volume=155|issue=1|year=2020|pages=44–45|issn=00257753|doi=10.1016/j.medcli.2020.04.007}}</ref><ref name="ByrneSado2020">{{cite journal|last1=Byrne|first1=Jonathan|last2=Sado|first2=Daniel|last3=O’Gallagher|first3=Kevin|last4=Hua|first4=Alina|title=Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19|journal=European Heart Journal|volume=41|issue=22|year=2020|pages=2130–2130|issn=0195-668X|doi=10.1093/eurheartj/ehaa253}}</ref>
**In the cases complicated by [[cardiac tamponade]], findings included: <ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref><ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref><ref name="ByrneSado2020">{{cite journal|last1=Byrne|first1=Jonathan|last2=Sado|first2=Daniel|last3=O’Gallagher|first3=Kevin|last4=Hua|first4=Alina|title=Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19|journal=European Heart Journal|volume=41|issue=22|year=2020|pages=2130–2130|issn=0195-668X|doi=10.1093/eurheartj/ehaa253}}</ref>
***Large [[pericardial effusion]]
***[[Right ventricle|Right ventricular]] [[diastolic]] collapse
***Increased [[respiratory]] variation in peak E-wave [[mitral]] inflow velocity
***Dilated [[inferior vena cava]]
 
For [[echocardiography]] findings in [[pericarditis]] in general, [[Pericarditis echocardiography and ultrasound|click here]].
 
====CT scan====
 
* On [[CT chest]], the reported cases showed [[pericardial effusion]].<ref name="CizgiciZencirkiran Agus2020">{{cite journal|last1=Cizgici|first1=Ahmet Yasar|last2=Zencirkiran Agus|first2=Hicaz|last3=Yildiz|first3=Mustafa|title=COVID-19 myopericarditis: It should be kept in mind in today's conditions|journal=The American Journal of Emergency Medicine|volume=38|issue=7|year=2020|pages=1547.e5–1547.e6|issn=07356757|doi=10.1016/j.ajem.2020.04.080}}</ref>
 
====Cardiac magnetic resonance====
 
 
*Finding of [[cardiac magnetic resonance]] in recently recovered [[covid-19]] [[patients]] was [[pericardial]] [[late gadolinium enhancement]] in 22% of [[patients]].<ref name="pmid32730619">{{cite journal |vauthors=Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, Shchendrygina A, Escher F, Vasa-Nicotera M, Zeiher AM, Vehreschild M, Nagel E |title=Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19) |journal=JAMA Cardiol |volume=5 |issue=11 |pages=1265–1273 |date=November 2020 |pmid=32730619 |pmc=7385689 |doi=10.1001/jamacardio.2020.3557 |url=}}</ref><ref name="MaceiraLopez-Lereu2020">{{cite journal|last1=Maceira|first1=Alicia M|last2=Lopez-Lereu|first2=Maria P|last3=Higueras Ortega|first3=Laura|last4=García-Gonzalez|first4=Pilar|last5=Broseta Torres|first5=Ricardo|last6=Solsona Caravaca|first6=Javier|last7=Ventura Perez|first7=Bruno|last8=Andres Soler|first8=Jorge|last9=Dominguez Mafe|first9=Eloy|last10=Monmeneu|first10=Jose V|last11=Voges|first11=Inga|title=Subacute perimyocarditis in a young patient with COVID-19 infection|journal=European Heart Journal - Case Reports|year=2020|issn=2514-2119|doi=10.1093/ehjcr/ytaa157}}</ref><ref name="InciardiLupi2020">{{cite journal|last1=Inciardi|first1=Riccardo M.|last2=Lupi|first2=Laura|last3=Zaccone|first3=Gregorio|last4=Italia|first4=Leonardo|last5=Raffo|first5=Michela|last6=Tomasoni|first6=Daniela|last7=Cani|first7=Dario S.|last8=Cerini|first8=Manuel|last9=Farina|first9=Davide|last10=Gavazzi|first10=Emanuele|last11=Maroldi|first11=Roberto|last12=Adamo|first12=Marianna|last13=Ammirati|first13=Enrico|last14=Sinagra|first14=Gianfranco|last15=Lombardi|first15=Carlo M.|last16=Metra|first16=Marco|title=Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)|journal=JAMA Cardiology|year=2020|issn=2380-6583|doi=10.1001/jamacardio.2020.1096}}</ref>
 
===Pericardial fluid analysis===
 
*In the reported cases of [[cardiac tamponade]] in [[COVID-19]] patients, [[pericardial fluid analysis]] from emergency [[pericardiocentesis]] showed:<ref name="DabbaghAurora2020" /><ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref>
**Largely [[exudative]] [[effusion]]
**High [[neutrophil|polymorphonuclear]] [[cell]] count
**High [[protein]] and [[LDH]] levels
 
*Other work-up included:
**Fluid [[cytology]] for [[malignant]] cells - negative
**[[Gram stain]], [[Acid-fast]] stain - negative
**[[Bacterial]], [[mycobacterial]] and [[fungal]] cultures - negative
**Serum [[auto-immune]] work-up - negative
 
* Since there are no established laboratory parameters to help distinguish [[COVID-19]]-related [[pericardial effusion]] from other etiologies, complete [[biochemical]], [[bacteria|bacteriological]] and [[cytological]] analysis of [[pericardial fluid]] is suggested to rule out other etiologies of [[pericardial effusion]].
* In a reported case, [[SARS-COV-2]] was detected by a RT-PCR kit in [[pericardial fluid]] of a [[patient]] presented with [[cardiac tamponade]]. <ref name="pmid32359887">{{cite journal |vauthors=Farina A, Uccello G, Spreafico M, Bassanelli G, Savonitto S |title=SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade |journal=Eur J Intern Med |volume=76 |issue= |pages=100–101 |date=June 2020 |pmid=32359887 |pmc=7177062 |doi=10.1016/j.ejim.2020.04.045 |url=}}</ref>


== Treatment ==
== Treatment ==
=== Medical Therapy ===
=== Medical Therapy ===
*There is no treatment for [disease name]; the mainstay of therapy is supportive care.
*[[NSAIDs]] and high-dose [[aspirin]] and are the mainstay of therapy for [[acute pericarditis]].<ref name="TomkowskiSwedberg2015">{{cite journal|last1=Tomkowski|first1=Witold|last2=Swedberg|first2=Karl|last3=Seferovic|first3=Petar|last4=Sabaté Tenas|first4=Manel|last5=Ristić|first5=Arsen D|last6=Pavie|first6=Alain|last7=Mayosi|first7=Bongani|last8=Maisch|first8=Bernhard|last9=Lionis|first9=Christos|last10=Klingel|first10=Karin|last11=Gueret|first11=Pascal|last12=Brucato|first12=Antonio|last13=Bogaert|first13=Jan|last14=Barón-Esquivias|first14=Gonzalo|last15=Badano|first15=Luigi|last16=Imazio|first16=Massimo|last17=Charron|first17=Philippe|last18=Adler|first18=Yehuda|last19=Achenbach|first19=Stephan|last20=Agewall|first20=Stefan|last21=Al-Attar|first21=Nawwar|last22=Angel Ferrer|first22=Juan|last23=Arad|first23=Michael|last24=Asteggiano|first24=Riccardo|last25=Bueno|first25=Héctor|last26=Caforio|first26=Alida L P|last27=Carerj|first27=Scipione|last28=Ceconi|first28=Claudio|last29=Evangelista|first29=Arturo|last30=Flachskampf|first30=Frank|last31=Giannakoulas|first31=George|last32=Gielen|first32=Stephan|last33=Habib|first33=Gilbert|last34=Kolh|first34=Philippe|last35=Lambrinou|first35=Ekaterini|last36=Lancellotti|first36=Patrizio|last37=Lazaros|first37=George|last38=Linhart|first38=Ales|last39=Meurin|first39=Philippe|last40=Nieman|first40=Koen|last41=Piepoli|first41=Massimo F|last42=Price|first42=Susanna|last43=Roos-Hesselink|first43=Jolien|last44=Roubille|first44=François|last45=Ruschitzka|first45=Frank|last46=Sagristà Sauleda|first46=Jaume|last47=Sousa-Uva|first47=Miguel|last48=Uwe Voigt|first48=Jens|last49=Luis Zamorano|first49=Jose|last50=Zamorano|first50=Jose Luis|last51=Aboyans|first51=Victor|last52=Achenbach|first52=Stephan|last53=Agewall|first53=Stefan|last54=Badimon|first54=Lina|last55=Barón-Esquivias|first55=Gonzalo|last56=Baumgartner|first56=Helmut|last57=Bax|first57=Jeroen J|last58=Bueno|first58=Héctor|last59=Carerj|first59=Scipione|last60=Dean|first60=Veronica|last61=Erol|first61=Çetin|last62=Fitzimons|first62=Donna|last63=Gaemperli|first63=Oliver|last64=Kirchhof|first64=Paulus|last65=Kolh|first65=Philippe|last66=Lancellotti|first66=Patrizio|last67=Lip|first67=Gregory YH|last68=Nihoyannopoulos|first68=Petros|last69=Piepoli|first69=Massimo F|last70=Ponikowski|first70=Piotr|last71=Roffi|first71=Marco|last72=Torbicki|first72=Adam|last73=Vaz Carneiro|first73=Antonio|last74=Windecker|first74=Stephan|last75=Shuka|first75=Naltin|last76=Sisakian|first76=Hamayak|last77=Mascherbauer|first77=Julia|last78=Isayev|first78=Elnur|last79=Shumavets|first79=Vadim|last80=Van Camp|first80=Guy|last81=Gatzov|first81=Plamen|last82=Hanzevacki|first82=Jadranka Separovic|last83=Moustra|first83=Hera Heracleous|last84=Linhart|first84=Ales|last85=Møller|first85=Jacob Eifer|last86=Aboleineen|first86=Mohamed Wafaie|last87=Põder|first87=Pentti|last88=Lehtonen|first88=Jukka|last89=Antov|first89=Slobodan|last90=Damy|first90=Thibaud|last91=Schieffer|first91=Bernhard|last92=Dimitriadis|first92=Kyriakos|last93=Kiss|first93=Robert Gabor|last94=Rafnsson|first94=Arnar|last95=Arad|first95=Michael|last96=Novo|first96=Salvatore|last97=Mirrakhimov|first97=Erkin|last98=Stradinš|first98=Peteris|last99=Kavoliuniene|first99=Ausra|last100=Codreanu|first100=Andrei|last101=Dingli |first101=Philip|last102=Vataman|first102=Eleonora|last103=El Hattaoui|first103=Mustapaha|last104=Samstad|first104=Stein Olav|last105=Hoffman|first105=Piotr|last106=Lopes|first106=Luís Rocha|last107=Dimulescu|first107=Doina Ruxandra|last108=Arutyunov|first108=Grigory P|last109=Pavlovic|first109=Milan|last110=Dúbrava|first110=Juraj|last111=Sauleda|first111=Jaume Sagristà|last112=Andersson|first112=Bert|last113=Müller|first113=Hajo|last114=Bouma|first114=Berto J|last115=Abaci|first115=Adnan|last116=Archbold|first116=Andrew|last117=Nesukay|first117=Elena|title=2015 ESC Guidelines for the diagnosis and management of pericardial diseases|journal=European Heart Journal|volume=36|issue=42|year=2015|pages=2921–2964|issn=0195-668X|doi=10.1093/eurheartj/ehv318}}</ref>
*[[Colchicine]] is recommended as first-line therapy for [[acute pericarditis]] as an adjunctive to [[NSAIDs]]/[[Aspririn]].
*The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
* The efficacy of [[colchicine]]  in [[acute pericarditis]] is related to reducing [[chest pain]], decreasing the [[leukocyte]] mobility and [[phagocytosis]] observing in [[inflammatory process]].<ref name="pmid26320112">{{cite journal |vauthors=Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C, Maisch B, Mayosi B, Pavie A, Ristic AD, Sabaté Tenas M, Seferovic P, Swedberg K, Tomkowski W |title=2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS) |journal=Eur Heart J |volume=36 |issue=42 |pages=2921–2964 |date=November 2015 |pmid=26320112 |pmc=7539677 |doi=10.1093/eurheartj/ehv318 |url=}}</ref>
*[Medical therapy 1] acts by [mechanism of action 1].
*[[Corticosteroids]] is reserved for cases with a contraindication or failure of first-line therapies.
*Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
*With early anecdotal reports linking  [[NSAIDs]] and [[corticosteroids]] with a worsening clinical condition in patients with [[COVID-19]], there have been recommendations against the use of these agents.<ref name="RussellMoss2020">{{cite journal|last1=Russell|first1=Beth|last2=Moss|first2=Charlotte|last3=Rigg|first3=Anne|last4=Van Hemelrijck|first4=Mieke|title=COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting?|journal=ecancermedicalscience|volume=14|year=2020|issn=17546605|doi=10.3332/ecancer.2020.1023}}</ref><ref name="BancosBernard2009">{{cite journal|last1=Bancos|first1=Simona|last2=Bernard|first2=Matthew P.|last3=Topham|first3=David J.|last4=Phipps|first4=Richard P.|title=Ibuprofen and other widely used non-steroidal anti-inflammatory drugs inhibit antibody production in human cells|journal=Cellular Immunology|volume=258|issue=1|year=2009|pages=18–28|issn=00088749|doi=10.1016/j.cellimm.2009.03.007}}</ref> However, according to the recommendations from the US [[Food and Drug Administration]] (FDA) and the [[Centers for Disease Control and Prevention]] (CDC), [[NSAIDs]] can be used when clinically indicated in [[COVID-19]] patients.<ref>{{cite web |url=https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19 |title=FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19 &#124; FDA |format= |work= |accessdate=}}</ref>
*There is no literature and existing data to provide definite evidence for or against the use of high- or low-dose [[aspirin]] when clinically indicated in patients with [[COVID-19]].  
=== Surgery ===
*In one of the reported cases of [[COVID-19]]-associated [[pericarditis]] and [[cardiac tamponade]], [[colchicine]] was well tolerated as [[monotherapy]].<ref>{{cite web |url=https://www.ejcrim.com/index.php/EJCRIM/article/view/1701/2100 |title=View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge |format= |work= |accessdate=}}</ref>
*Surgery is the mainstay of therapy for [disease name].
*In another case of [[COVID-19]] and [[cardiac tamponade]], the combination of [[corticosteroids]] and [[colchicine]] was well tolerated and successful.<ref name="DabbaghAurora2020">{{cite journal|last1=Dabbagh|first1=Mohammed F.|last2=Aurora|first2=Lindsey|last3=D’Souza|first3=Penny|last4=Weinmann|first4=Allison J.|last5=Bhargava|first5=Pallavi|last6=Basir|first6=Mir B.|title=Cardiac Tamponade Secondary to COVID-19|journal=JACC: Case Reports|year=2020|issn=26660849|doi=10.1016/j.jaccas.2020.04.009}}</ref>
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
*Response to treatment can be monitored with serial [[echocardiogram|transthoracic echocardiogram]] (TTE).
*[Surgical procedure] can only be performed for patients with [disease stage] [disease name].
 
===Surgery===
=== Prevention ===
*In all the reported cases of [[COVID-19]] with large [[effusions]] and [[cardiac tamponade]], [[pericardiocentesis]] showed improvement in [[clinical]] [[condition]].
*There are no primary preventive measures available for [disease name].
*Response to treatment can be monitored with serial [[echocardiogram|transthoracic echocardiogram]] ([[TTE]]).
 
*Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
===Primary Prevention===
*There are no established measures for the [[primary prevention]] of [[COVID-19]]-associated [[pericarditis]].
*For primary preventive measures of [COVID-19], [[COVID-19 primary prevention|click here]].


*Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
===Secondary Prevention===
*There are no established measures for the [[secondary prevention]] of [[COVID-19]]-associated [[pericarditis]].
*For secondary preventive measures of [[COVID-19]], [[COVID-19 secondary prevention|click here]].


==References==
==References==

Latest revision as of 05:03, 17 October 2021

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Main article: COVID-19

For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here
For COVID-19 patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Mounika Reddy Vadiyala, M.B.B.S.[3]

Synonyms and keywords: Novel coronavirus, COVID-19, Wuhan coronavirus, coronavirus Disease-19, coronavirus disease 2019, SARS-CoV-2, COVID-19, COVID-19, 2019-nCoV, 2019 novel coronavirus, cardiovascular finding in COVID-19, pericardial injury in COVID-19, pericarditis, pericarditis in COVID-19, COVID-19-associated Pericarditis, SARS-CoV2-associated pericarditis, myocardial injury in COVID-19, COVID-19 pericarditis

Overview

COVID-19 caused by the novel coronavirus, also known as SARS-CoV-2 mainly affects the lungs, causing severe acute respiratory syndrome. It has been proposed that covid-19 invades through the angiotensin-converting enzyme 2 (ACE2) receptors present abundantly not only in the lungs but also in the heart, endothelium, cardiomyocytes, epicardial adipose tissue adjacent to the visceral pericardium.In addition, Inflammatory cascade may prompt to cardiac manifestations in covid-19. Acute pericarditis is one of the cardiac complications of covid-19 resulting from the inflammation of pericardial sac surrounding the heart. Few cases of covid-19-associated pericarditis have been reported whether none of them were proven to be due to direct invasion of pericardium by corona virus. Reports on large pericardial effusion and cardiac tamponade are rare in covid-19. Pericarditis after vaccination of covid-19 has been reported with few incidence in elderly patients.

Historical Perspective

Classification

Pathophysiology

Causes

Pericarditis in COVID-19 is likely caused by:

Differentiating COVID-19-associated pericarditis from other diseases

  • For further information about the differential diagnosis, click here.
  • For further information about the differential diagnosis of COVID-19, click here.

Epidemiology and Demographics

Age

Gender

Race

Natural History, Complications and Prognosis

Diagnosis

Symptoms

Symptoms of pericarditis in COVID-19 may include the following:

Physical Examination

Physical examination may be remarkable for:

Laboratory Findings

Inflammatory biomarkers

Cardiac biomarkers

Electrocardiogram

Imaging

Chest X-ray

Echocardiography

For echocardiography findings in pericarditis in general, click here.

CT scan

Cardiac magnetic resonance

Pericardial fluid analysis

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

References

  1. ↑ Tung-Chen Y (July 2020). "Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?". Med Clin (Engl Ed). 155 (1): 44–45. doi:10.1016/j.medcle.2020.06.001. PMC 7333598 Check |pmc= value (help). PMID 32835093 Check |pmid= value (help).
  2. ↑ https://www.cdc.gov/coronavirus/2019-ncov/about/index.html. Missing or empty |title= (help)
  3. ↑ Lu, Jian; Cui, Jie; Qian, Zhaohui; Wang, Yirong; Zhang, Hong; Duan, Yuange; Wu, Xinkai; Yao, Xinmin; Song, Yuhe; Li, Xiang; Wu, Changcheng; Tang, Xiaolu (2020). "On the origin and continuing evolution of SARS-CoV-2". National Science Review. doi:10.1093/nsr/nwaa036. ISSN 2095-5138.
  4. ↑ Huang, Chaolin; Wang, Yeming; Li, Xingwang; Ren, Lili; Zhao, Jianping; Hu, Yi; Zhang, Li; Fan, Guohui; Xu, Jiuyang; Gu, Xiaoying; Cheng, Zhenshun; Yu, Ting; Xia, Jiaan; Wei, Yuan; Wu, Wenjuan; Xie, Xuelei; Yin, Wen; Li, Hui; Liu, Min; Xiao, Yan; Gao, Hong; Guo, Li; Xie, Jungang; Wang, Guangfa; Jiang, Rongmeng; Gao, Zhancheng; Jin, Qi; Wang, Jianwei; Cao, Bin (2020). "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China". The Lancet. 395 (10223): 497–506. doi:10.1016/S0140-6736(20)30183-5. ISSN 0140-6736.
  5. ↑ https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html. Missing or empty |title= (help)
  6. ↑ "WHO | Novel Coronavirus – China".
  7. ↑ "Coronavirus (COVID-19) events as they happen".
  8. ↑ "Coronavirus (COVID-19) events as they happen".
  9. ↑ 9.0 9.1 Tomkowski, Witold; Swedberg, Karl; Seferovic, Petar; Sabaté Tenas, Manel; Ristić, Arsen D; Pavie, Alain; Mayosi, Bongani; Maisch, Bernhard; Lionis, Christos; Klingel, Karin; Gueret, Pascal; Brucato, Antonio; Bogaert, Jan; Barón-Esquivias, Gonzalo; Badano, Luigi; Imazio, Massimo; Charron, Philippe; Adler, Yehuda; Achenbach, Stephan; Agewall, Stefan; Al-Attar, Nawwar; Angel Ferrer, Juan; Arad, Michael; Asteggiano, Riccardo; Bueno, Héctor; Caforio, Alida L P; Carerj, Scipione; Ceconi, Claudio; Evangelista, Arturo; Flachskampf, Frank; Giannakoulas, George; Gielen, Stephan; Habib, Gilbert; Kolh, Philippe; Lambrinou, Ekaterini; Lancellotti, Patrizio; Lazaros, George; Linhart, Ales; Meurin, Philippe; Nieman, Koen; Piepoli, Massimo F; Price, Susanna; Roos-Hesselink, Jolien; Roubille, François; Ruschitzka, Frank; Sagristà Sauleda, Jaume; Sousa-Uva, Miguel; Uwe Voigt, Jens; Luis Zamorano, Jose; Zamorano, Jose Luis; Aboyans, Victor; Achenbach, Stephan; Agewall, Stefan; Badimon, Lina; Barón-Esquivias, Gonzalo; Baumgartner, Helmut; Bax, Jeroen J; Bueno, Héctor; Carerj, Scipione; Dean, Veronica; Erol, Çetin; Fitzimons, Donna; Gaemperli, Oliver; Kirchhof, Paulus; Kolh, Philippe; Lancellotti, Patrizio; Lip, Gregory YH; Nihoyannopoulos, Petros; Piepoli, Massimo F; Ponikowski, Piotr; Roffi, Marco; Torbicki, Adam; Vaz Carneiro, Antonio; Windecker, Stephan; Shuka, Naltin; Sisakian, Hamayak; Mascherbauer, Julia; Isayev, Elnur; Shumavets, Vadim; Van Camp, Guy; Gatzov, Plamen; Hanzevacki, Jadranka Separovic; Moustra, Hera Heracleous; Linhart, Ales; Møller, Jacob Eifer; Aboleineen, Mohamed Wafaie; Põder, Pentti; Lehtonen, Jukka; Antov, Slobodan; Damy, Thibaud; Schieffer, Bernhard; Dimitriadis, Kyriakos; Kiss, Robert Gabor; Rafnsson, Arnar; Arad, Michael; Novo, Salvatore; Mirrakhimov, Erkin; Stradinš, Peteris; Kavoliuniene, Ausra; Codreanu, Andrei; Dingli, Philip; Vataman, Eleonora; El Hattaoui, Mustapaha; Samstad, Stein Olav; Hoffman, Piotr; Lopes, Luís Rocha; Dimulescu, Doina Ruxandra; Arutyunov, Grigory P; Pavlovic, Milan; Dúbrava, Juraj; Sauleda, Jaume Sagristà; Andersson, Bert; Müller, Hajo; Bouma, Berto J; Abaci, Adnan; Archbold, Andrew; Nesukay, Elena (2015). "2015 ESC Guidelines for the diagnosis and management of pericardial diseases". European Heart Journal. 36 (42): 2921–2964. doi:10.1093/eurheartj/ehv318. ISSN 0195-668X.
  10. ↑ Amoozgar B, Kaushal V, Mubashar U, Sen S, Yousaf S, Yotsuya M (September 2020). "Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection: A case report". Medicine (Baltimore). 99 (37): e22093. doi:10.1097/MD.0000000000022093. PMC 7489591 Check |pmc= value (help). PMID 32925751 Check |pmid= value (help).
  11. ↑ 11.0 11.1 Basso C, Leone O, Rizzo S, De Gaspari M, van der Wal AC, Aubry MC, Bois MC, Lin PT, Maleszewski JJ, Stone JR (October 2020). "Pathological features of COVID-19-associated myocardial injury: a multicentre cardiovascular pathology study". Eur Heart J. 41 (39): 3827–3835. doi:10.1093/eurheartj/ehaa664. PMC 7543528 Check |pmc= value (help). PMID 32968776 Check |pmid= value (help).
  12. ↑ Patel AB, Verma A (May 2020). "COVID-19 and Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: What Is the Evidence?". JAMA. 323 (18): 1769–1770. doi:10.1001/jama.2020.4812. PMID 32208485 Check |pmid= value (help).
  13. ↑ 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 Dabbagh, Mohammed F.; Aurora, Lindsey; D’Souza, Penny; Weinmann, Allison J.; Bhargava, Pallavi; Basir, Mir B. (2020). "Cardiac Tamponade Secondary to COVID-19". JACC: Case Reports. doi:10.1016/j.jaccas.2020.04.009. ISSN 2666-0849.
  14. ↑ 14.0 14.1 14.2 14.3 14.4 Inciardi, Riccardo M.; Lupi, Laura; Zaccone, Gregorio; Italia, Leonardo; Raffo, Michela; Tomasoni, Daniela; Cani, Dario S.; Cerini, Manuel; Farina, Davide; Gavazzi, Emanuele; Maroldi, Roberto; Adamo, Marianna; Ammirati, Enrico; Sinagra, Gianfranco; Lombardi, Carlo M.; Metra, Marco (2020). "Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)". JAMA Cardiology. doi:10.1001/jamacardio.2020.1096. ISSN 2380-6583.
  15. ↑ 15.0 15.1 Maceira, Alicia M; Lopez-Lereu, Maria P; Higueras Ortega, Laura; García-Gonzalez, Pilar; Broseta Torres, Ricardo; Solsona Caravaca, Javier; Ventura Perez, Bruno; Andres Soler, Jorge; Dominguez Mafe, Eloy; Monmeneu, Jose V; Voges, Inga (2020). "Subacute perimyocarditis in a young patient with COVID-19 infection". European Heart Journal - Case Reports. doi:10.1093/ehjcr/ytaa157. ISSN 2514-2119.
  16. ↑ 16.0 16.1 16.2 16.3 16.4 Byrne, Jonathan; Sado, Daniel; O’Gallagher, Kevin; Hua, Alina (2020). "Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19". European Heart Journal. 41 (22): 2130–2130. doi:10.1093/eurheartj/ehaa253. ISSN 0195-668X.
  17. ↑ 17.0 17.1 17.2 17.3 17.4 Cizgici, Ahmet Yasar; Zencirkiran Agus, Hicaz; Yildiz, Mustafa (2020). "COVID-19 myopericarditis: It should be kept in mind in today's conditions". The American Journal of Emergency Medicine. 38 (7): 1547.e5–1547.e6. doi:10.1016/j.ajem.2020.04.080. ISSN 0735-6757.
  18. ↑ 18.0 18.1 18.2 18.3 18.4 Tung-Chen, Yale (2020). "Acute pericarditis due to COVID-19 infection: An underdiagnosed disease?". Medicina Clínica. 155 (1): 44–45. doi:10.1016/j.medcli.2020.04.007. ISSN 0025-7753.
  19. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".
  20. ↑ Miró Ò, Llorens P, Jiménez S, Piñera P, Burillo-Putze G, Martín A, Martín-Sánchez FJ, González Del Castillo J (August 2020). "Frequency of five unusual presentations in patients with COVID-19: results of the UMC-19-S1". Epidemiol Infect. 148: e189. doi:10.1017/S0950268820001910. PMC 7477462 Check |pmc= value (help). PMID 32843127 Check |pmid= value (help).
  21. ↑ Hanley B, Naresh KN, Roufosse C, Nicholson AG, Weir J, Cooke GS, Thursz M, Manousou P, Corbett R, Goldin R, Al-Sarraj S, Abdolrasouli A, Swann OC, Baillon L, Penn R, Barclay WS, Viola P, Osborn M (October 2020). "Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study". Lancet Microbe. 1 (6): e245–e253. doi:10.1016/S2666-5247(20)30115-4. PMC 7440861 Check |pmc= value (help). PMID 32844161 Check |pmid= value (help).
  22. ↑ Diaz GA, Parsons GT, Gering SK, Meier AR, Hutchinson IV, Robicsek A (September 2021). "Myocarditis and Pericarditis After Vaccination for COVID-19". JAMA. 326 (12): 1210–1212. doi:10.1001/jama.2021.13443. PMID 34347001 Check |pmid= value (help).
  23. ↑ Kloos JA (December 2015). "Characteristics, Complications, and Treatment of Acute Pericarditis". Crit Care Nurs Clin North Am. 27 (4): 483–97. doi:10.1016/j.cnc.2015.08.001. PMID 26567493.
  24. ↑ Hua A, O'Gallagher K, Sado D, Byrne J (June 2020). "Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19". Eur Heart J. 41 (22): 2130. doi:10.1093/eurheartj/ehaa253. PMC 7184427 Check |pmc= value (help). PMID 32227076 Check |pmid= value (help).
  25. ↑ Dabbagh MF, Aurora L, D'Souza P, Weinmann AJ, Bhargava P, Basir MB (July 2020). "Cardiac Tamponade Secondary to COVID-19". JACC Case Rep. 2 (9): 1326–1330. doi:10.1016/j.jaccas.2020.04.009. PMC 7177077 Check |pmc= value (help). PMID 32328588 Check |pmid= value (help).
  26. ↑ Fox K, Prokup JA, Butson K, Jordan K (July 2020). "Acute Effusive Pericarditis: A Late Complication of COVID-19". Cureus. 12 (7): e9074. doi:10.7759/cureus.9074. PMC 7348211 Check |pmc= value (help). PMID 32656050 Check |pmid= value (help).
  27. ↑ Cizgici AY, Zencirkiran Agus H, Yildiz M (July 2020). "COVID-19 myopericarditis: It should be kept in mind in today's conditions". Am J Emerg Med. 38 (7): 1547.e5–1547.e6. doi:10.1016/j.ajem.2020.04.080. PMC 7187845 Check |pmc= value (help). PMID 32360119 Check |pmid= value (help).
  28. ↑ 28.0 28.1 Cremer PC, Kumar A, Kontzias A, Tan CD, Rodriguez ER, Imazio M, Klein AL (November 2016). "Complicated Pericarditis: Understanding Risk Factors and Pathophysiology to Inform Imaging and Treatment". J Am Coll Cardiol. 68 (21): 2311–2328. doi:10.1016/j.jacc.2016.07.785. PMID 27884251.
  29. ↑ "Diagnosis of acute pericarditis".
  30. ↑ "Diagnosis of acute pericarditis".
  31. ↑ Imazio, Massimo; Demichelis, Brunella; Cecchi, Enrico; Belli, Riccardo; Ghisio, Aldo; Bobbio, Marco; Trinchero, Rita (2003). "Cardiac troponin i in acute pericarditis". Journal of the American College of Cardiology. 42 (12): 2144–2148. doi:10.1016/j.jacc.2003.02.001. ISSN 0735-1097.
  32. ↑ Bonnefoy, E (2000). "Serum cardiac troponin I and ST-segment elevation in patients with acute pericarditis". European Heart Journal. 21 (10): 832–836. doi:10.1053/euhj.1999.1907. ISSN 0195-668X.
  33. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".
  34. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".
  35. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".
  36. ↑ "Diagnosis of acute pericarditis".
  37. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".
  38. ↑ Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, Shchendrygina A, Escher F, Vasa-Nicotera M, Zeiher AM, Vehreschild M, Nagel E (November 2020). "Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)". JAMA Cardiol. 5 (11): 1265–1273. doi:10.1001/jamacardio.2020.3557. PMC 7385689 Check |pmc= value (help). PMID 32730619 Check |pmid= value (help).
  39. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".
  40. ↑ Farina A, Uccello G, Spreafico M, Bassanelli G, Savonitto S (June 2020). "SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade". Eur J Intern Med. 76: 100–101. doi:10.1016/j.ejim.2020.04.045. PMC 7177062 Check |pmc= value (help). PMID 32359887 Check |pmid= value (help).
  41. ↑ Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C, Maisch B, Mayosi B, Pavie A, Ristic AD, Sabaté Tenas M, Seferovic P, Swedberg K, Tomkowski W (November 2015). "2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS)". Eur Heart J. 36 (42): 2921–2964. doi:10.1093/eurheartj/ehv318. PMC 7539677 Check |pmc= value (help). PMID 26320112.
  42. ↑ Russell, Beth; Moss, Charlotte; Rigg, Anne; Van Hemelrijck, Mieke (2020). "COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting?". ecancermedicalscience. 14. doi:10.3332/ecancer.2020.1023. ISSN 1754-6605.
  43. ↑ Bancos, Simona; Bernard, Matthew P.; Topham, David J.; Phipps, Richard P. (2009). "Ibuprofen and other widely used non-steroidal anti-inflammatory drugs inhibit antibody production in human cells". Cellular Immunology. 258 (1): 18–28. doi:10.1016/j.cellimm.2009.03.007. ISSN 0008-8749.
  44. ↑ "FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19 | FDA".
  45. ↑ "View of Acute Pericarditis and Cardiac Tamponade in a Patient with COVID-19: A Therapeutic Challenge".

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