Department of Anesthesia and Intensive Care Medicine, Academic Hospital of Udine, Piazzale S.M. della Misericordia, 15, 33100, Udine, Italy.
Department of Medicine, University of Udine, Udine, Italy.
Inflammation. 2022 Feb;45(1):1-5. doi: 10.1007/s10753-021-01563-3. Epub 2021 Sep 17.
Novel Coronavirus Disease in most cases produces mild symptoms which resolve after a few days. Some authors hypothesized that SARS-CoV-2 infection could trigger excessive cytokine production leading to a severe multi-organ disease requiring intensive care admission. Respiratory and neurological symptoms are the most frequently reported manifestation of the disease. Indeed, cardiac involvement is reported mostly as a part of a systemic disease. Few isolated cardiac manifestations of COVID-19 infection have been described. We report herein a case of SARS-CoV-2 related severe isolated pericardial involvement requiring ICU admission due to cardiac tamponade needing urgent drainage. Analysis of pericardial fluid from drainage demonstrated a higher cytokine concentration than blood values. Other causes of pericardial disease, such as autoimmunity, bacterial or other than COVID-19 infection, neoplasms or acute myocardial infarction were also evaluated, but all tests confirmed negative results. The suspicion of isolated involvement of the pericardium was therefore demonstrated by the analysis of cytokines which strongly support our hypothesis.
新型冠状病毒病在大多数情况下产生轻微症状，几天后即可缓解。一些作者假设，SARS-CoV-2 感染可能会引发过度的细胞因子产生，导致需要重症监护入院的严重多器官疾病。呼吸道和神经系统症状是该疾病最常报告的表现。实际上，心脏受累主要作为全身性疾病的一部分报告。已经描述了少数孤立的 COVID-19 感染的心脏表现。我们在此报告了一例与 SARS-CoV-2 相关的严重孤立性心包受累的病例，由于心脏压塞需要紧急引流，因此需要入住 ICU。引流的心包液分析显示细胞因子浓度高于血液值。还评估了其他引起心包疾病的原因，如自身免疫、细菌或非 COVID-19 感染、肿瘤或急性心肌梗死，但所有检查均证实为阴性结果。通过对细胞因子的分析证实了心包的孤立受累的怀疑，这强烈支持了我们的假设。
