Post COVID-19 hemorrhagic pericardial effusion; A case report with literature review

• Published in: Annals of medicine and surgery Vol. 74; p. 103300
• Main Authors: Hama Amin, Bnar J., Kakamad, Fahmi H., Hamasaeed, Ahmed Gh, Salih, Abdulwahid M., Hamasaeed, Muhammed Gh, Ali, Razhan K., Salih, Bestoon KH
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2022; Elsevier
• Subjects: Case Report; COVID-19; Hemorrhage; Pericardial effusion; Post COVID-19 syndrome; SARS-CoV-2; COVID-19; Post COVID-19 syndrome; SARS-CoV-2; Hemorrhage; Pericardial effusion
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103300

Pericardial effusion (PE) related to COVID-19 has rarely been observed, with most reported cases being non-hemorrhagic. This study aims to present a rare case of post-COVID-19 hemorrhagic PE. A 44-year-old male presented with shortness of breath upon exertion, palpitation, and left-sided chest tightness. He was a recently recovered from COVID-19. He was conscious, oriented, tachypneic, and tachycardic. Chest examination revealed a mixture of fine and coarse crackles along with muffled heart sounds. He had elevated D-dimer, C-reactive protein, prothrombin time, and aPTT. Computed tomography pulmonary angiogram showed acute pulmonary thromboembolism involving the posterior segmental lobar branch of the left lower lobe with concomitant pulmonary infarction. Echocardiography showed severe PE without diastolic collapse. Pericardial drainage was performed and by the 2nd day, there was no more effusion. On the 7th day, the patient developed severe complications which led to cardiac arrest. PE is a collection of fluid in the pericardium. It has been rarely observed in relation to COVID-19, both during and after the viral infection. If PE is suspected, Echocardiography can be used to confirm its diagnosis. There is no standard management for these cases and only non-hemorrhagic patients with mild to moderate effusion can be treated using conservative measures. Hemorrhagic PE can be a rare but possible post-COVID-19 sequel, and echocardiography can be used to confirm its diagnosis. Drainage is necessary to resolve the effusion. •Hemorrhagic pericardial effusion is the buildup of blood and fluid in the pericardium.•It is a rare but possible complication of active or resolved COVID-19.•Drainage is required to relieve this effusion as conservative measures are ineffective.•This report presents a rare case of post-COVID-19 hemorrhagic pericardial effusion.