Assessment of Clinical Characteristics and Outcomes of COVID-19 Patients with Pericardial Effusion

Evidence shows increased identification of cardiac involvement in patients with COVID-19 with a more critical prognosis. The study aimed to assess the outcomes of COVID-19 patients with pericardial effusion (PE) disease in comparison with a control group. Sixty-One COVID-19 patients who were referred to Shariati hospital in Tehran, Iran, from June 2020 to June 2020 were included. The diagnosis of COVID-19 was according to WHO interim guidance. Eleven cases were with pericardial effusion, and two patients were with a diagnosis of tamponade and pericardial synthesis. Other forty-six Covid-19 cases were as the control group. The majority of patients (54.0%) were in the age group of 50–70 years. Also, 62.2% of cases were male. In PE group compared to non-PE group patients had ESR>50 mm/hour [13(86%) vs. 3(66%), P=0.045), hypernatremia [4(26%) vs. 1(2.1%) P=0.007].  In non-PE group compared to PE group patients had PCT>ULN (ug/L) [21(42) vs. 4(26.7), P=0.035].  There was no significant difference between results of lung CT scan (ground glass (GG), pericardial effusion, and pleural effusion) and tachypnea, positive RT-PCR, and lab in the mild PE group compared to the tamponade group. The incidence of shock (or SBP<100) was more in the mild PE group compared to the tamponade group (P=0.048). There was no significant difference in outcomes (all-cause mortality, discharge, ICU admission and duration, shock, MI intubation, and time of admission) between PE and non-PE groups and subgroups of PE (P>0.05). The results showed pericardial effusion involvement could happen with COVID-19 patients even without differences in all-cause mortality, discharge, ICU admission and duration, MI, time of admission, and intubation. Although, there was a significant difference in hypernatremia and increased ESR level in the PE group. Also, our data provide some reassurance that PE is not a poor prognostic factor in COVID-19 infection.