Mangaloiu David V, Tilișcan Cătălin, Răriș Alexandra D, Negru Anca R, Molagic Violeta, Vișan Constanta A, Stratan Laurențiu M, Mihai Nicoleta, Aramă Ștefan S, Aramă Victoria
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania.
National Institute for Infectious Diseases "Prof. Dr. Matei Balş", 021105 Bucharest, Romania.
J Clin Med. 2024 Jun 27;13(13):3749. doi: 10.3390/jcm13133749.
: Pericardial and pleural effusions are two complications recently described in patients hospitalized with COVID-19 infections. There are several mechanisms that have been proposed and refer to SARS-CoV-2's capacity to bind to cell surfaces via various receptors and its broad tissue tropism that might cause significant complications. The aim of the present study is to evaluate the incidence of pericardial and pleural effusions during COVID-19 infection as well as to determine the risk factors associated with these complications. : We conducted a retrospective single-center study that included 346 patients admitted to the National Institute of Infectious Disease "Prof. Dr. Matei Bals" (Bucharest, Romania), from 1 January to 25 May 2021, during the third wave of the pandemic. Socio-demographic and anthropometric data were collected for each patient. The patients were evaluated clinically, biologically, and radiologically within 48 h of admission. Patients were divided into 3 groups: (1) patients with pericardial effusions-18; (2) patients with pleural effusions-28; (3) patients without pericardial/pleural effusions-294. : After exclusion criteria were applied, 337 patients were analyzed. The median age of the participants was 58.26 ± 14.58 years. More than half of the hospitalized patients had associated respiratory failure (61.5%), of which 2.7% had a critical form of the disease and 58.8% had a severe form. The cumulative percentage for pericardial and pleural effusions for the study group was 12.8% (43 patients out of 337). The prevalence of pericardial effusion was 5.3%, twice more frequent among male respondents. Pleural effusion was identified in 8.3% patients. Most patients had unilateral effusion (17), compared to 11 patients who had bilateral involvement. Based on laboratory results, patients with pericardial and pleural effusions exhibited increased levels of C reactive protein, erythrocyte sedimentation rate, NT proBNP, and a higher value of neutrophil/lymphocyte count ratio. In contrast to patients without pleural and pericardial effusions, those with these symptoms experienced a higher frequency of severe or critical illness and longer hospital stays. : Pericardial and pleural effusions can complicate COVID-19 infections. In our study, the prevalence of pericardial and pleural effusions in hospitalized patients was low, being associated with the same comorbidities and a number of clinical and biological parameters.
心包积液和胸腔积液是近期在感染新型冠状病毒肺炎（COVID-19）的住院患者中发现的两种并发症。目前已提出多种机制，这些机制与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过各种受体与细胞表面结合的能力及其广泛的组织嗜性有关，而这种广泛的组织嗜性可能会导致严重并发症。本研究的目的是评估COVID-19感染期间心包积液和胸腔积液的发生率，并确定与这些并发症相关的危险因素。
我们进行了一项回顾性单中心研究，研究对象为2021年1月1日至5月25日第三波疫情期间入住罗马尼亚布加勒斯特“马特伊·巴尔什教授”国家传染病研究所的346例患者。收集了每位患者的社会人口统计学和人体测量数据。患者在入院后48小时内接受临床、生物学和放射学评估。患者被分为3组：（1）心包积液患者18例；（2）胸腔积液患者28例；（3）无心包/胸腔积液患者294例。
应用排除标准后，对337例患者进行了分析。参与者的中位年龄为58.26±14.58岁。超过一半的住院患者伴有呼吸衰竭（61.5%），其中2.7%为危重型，58.8%为重型。研究组心包积液和胸腔积液的累积发生率为12.8%（337例患者中有43例）。心包积液的患病率为5.3%，在男性患者中出现的频率是女性的两倍。8.3%的患者发现有胸腔积液。大多数患者为单侧积液（17例），双侧积液的患者有11例。根据实验室结果，心包积液和胸腔积液患者的C反应蛋白、红细胞沉降率、N末端脑钠肽前体（NT proBNP）水平升高，中性粒细胞/淋巴细胞计数比值更高。与无心包和胸腔积液的患者相比，有这些症状的患者出现重症或危重症的频率更高，住院时间更长。
心包积液和胸腔积液会使COVID-19感染复杂化。在我们的研究中，住院患者心包积液和胸腔积液的患病率较低，与相同的合并症以及一些临床和生物学参数相关。
