Discussion
Most admitted patients of COVID-19 are more than 70 years old and have
cardiovascular comorbidities. The patients most vulnerable to the
disease are those with chronic diseases, including cardiovascular
disease [HF, ischemic heart disease, hypertension, diabetes mellitus
(DM)] (7,8). As cases of cardiac manifestation are increasing, it is
important to consider other causes than pulmonary for dyspnea in such
patients. It is important to consider follow up in discharged patients
with x-ray controls and possibly echocardiograms if dyspnea does not
resolve totally to their previous baseline. Pericarditis and pericardial
effusion are rare complications of COVID-19 and the approach of
management have not been totally described (5,6).
The management of pericarditis starts with a TTE to rule out pericardial
effusion or tamponade. If there is no hemodynamic compromise a
pharmacological approach can be considered. High dose aspirin and NSAIDs
are described as the first line management in such cases. Colchicine can
be added as an additional treatment. However, if the effusion progresses
or there is hemodynamic compromise a pericardiocentesis must be
attempted (9).
As COVID-19 cases become increasingly common and of daily management in
hospitals, it is important to be aware of their possible complications.
With this case we want to highlight the importance of follow-up at
discharge of patients with COVID-19 and the value of clinical ultrasound
in patients presenting with dyspnea in the emergency room.