Abstract
Aims
Acute pericarditis is considered one of the cardiovascular complications of COVID-19. The published data suggest that the diagnosis of acute pericarditis in patients with COVID-19 infection may be more frequent than usually diagnosed and as a consequence, undertreated. The proposed investigation is a retrospective observational study in which 170 patients, admitted to an Intensive Care Unit because of a COVID-19 diagnosis, were analysed. All patients underwent cardiological evaluation including a bedside echocardiogram. The aim of the study was to evaluate the prevalence and clinical implications of acute pericarditis diagnosed through the presence of pericardial effusion.
Methods and results
The proposed investigation is a retrospective observational study enrolling patients admitted to Intensive Care Unit of Madonna del Soccorso Hospital (San Benedetto del Tronto, Italy) because of a SARS-CoV-2 induced severe acute respiratory syndrome. No. 170 patients, admitted from 1 April 2020 to 30 April 2021, were enrolled. All patients presented a variable picture of bilateral interstitial pneumonia characterized by ground glass opacifications at HR-Chest CT. Some patients underwent oro-tracheal intubation and invasive ventilation. All patients underwent cardiological consultation including a transthoracic bedside echocardiogram, using ultrasound E9-GE machine (Boston, MA, USA). Demographic, laboratory and clinical data were collected for all enrolled patients (Table 1). The diagnosis of acute pericarditis was defined by: (i) different degree of pericardial effusion; (ii) C-reactive proteine elevation. All patients were divided in two groups: (1) pericarditis group (a); (2) pericarditis-free group (b). Of 170 enrolled patient, 51 were females (30%) and 119 were males (70%). Median age for all patients was 67.6 ± 13.3 [females: 70.5 (±16.2); males: 66.4 (±11.7)]. Of 170, n. 60 patients had a diagnosis of acute pericarditis (32.2%). Group A (patient with acute pericarditis) consisted of 60 patients, age 69.2 (±12.6), 39 (65%) male [age 69.3 (±10.6)], 21 (35%) female [age 69.1 (±16.0)]. Of 60, only 6 had a pericardial effusion >10 mm (10%); the remaining group A-patients (90%) had a mild pericardial effusion (<10 mm). No patient had tamponade picture. Group B (pericarditis-free patients) included 110 patients, age 66.7 (±13.7), 80 (72.7%) males [age 65.0 (±12.1)], 30 (27.3%) females [age 71.4 (±16.6)]. Group A-patients (with pericarditis) had more days of intubation and a prolonged global hospital stay compared with group B (pericarditis-free). Other demographic, clinical and laboratory parameters were similar between the two groups.
Conclusions
Pericarditis is a frequent cardiovascular complication of COVID-19 (32.2% in our study). It may have clinical and prognostic implications.
Impact of adverse events on patient outcomes in a Japanese intensive care unit: a retrospective observational study
