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Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?

With the emerging success of the COVID-19 vaccination programs, the incidence of acute COVID-19 will decrease. However, given the high number of people who contracted SARS-CoV-2 infection and recovered, we will be faced with a significant number of patients with persistent symptoms even months after...

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Autores principales: Carubbi, Francesco, Alunno, Alessia, Leone, Silvia, Di Gregorio, Nicoletta, Mancini, Bernardina, Viscido, Angelo, Del Pinto, Rita, Cicogna, Sabrina, Grassi, Davide, Ferri, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540566/
https://www.ncbi.nlm.nih.gov/pubmed/34696427
http://dx.doi.org/10.3390/v13101997
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author Carubbi, Francesco
Alunno, Alessia
Leone, Silvia
Di Gregorio, Nicoletta
Mancini, Bernardina
Viscido, Angelo
Del Pinto, Rita
Cicogna, Sabrina
Grassi, Davide
Ferri, Claudio
author_facet Carubbi, Francesco
Alunno, Alessia
Leone, Silvia
Di Gregorio, Nicoletta
Mancini, Bernardina
Viscido, Angelo
Del Pinto, Rita
Cicogna, Sabrina
Grassi, Davide
Ferri, Claudio
author_sort Carubbi, Francesco
collection PubMed
description With the emerging success of the COVID-19 vaccination programs, the incidence of acute COVID-19 will decrease. However, given the high number of people who contracted SARS-CoV-2 infection and recovered, we will be faced with a significant number of patients with persistent symptoms even months after their COVID-19 infection. In this setting, long COVID and its cardiovascular manifestations, including pericarditis, need to become a top priority for healthcare systems as a new chronic disease process. Concerning the relationship between COVID-19 and pericardial diseases, pericarditis appears to be common in the acute infection but rare in the postacute period, while small pericardial effusions may be relatively common in the postacute period of COVID-19. Here, we reported a series of 7 patients developing pericarditis after a median of 20 days from clinical and virological recovery from SARS-CoV-2 infection. We excluded specific identifiable causes of pericarditis, hence we speculate that these cases can be contextualized within the clinical spectrum of long COVID. All our patients were treated with a combination of colchicine and either ASA or NSAIDs, but four of them did not achieve a clinical response. When switched to glucocorticoids, these four patients recovered with no recurrence during drug tapering. Based on this observation and on the latency of pericarditis occurrence (a median of 20 days after a negative nasopharyngeal swab), could be suggested that post-COVID pericarditis may be linked to ongoing inflammation sustained by the persistence of viral nucleic acid without virus replication in the pericardium. Therefore, glucocorticoids may be a suitable treatment option in patients not responding or intolerant to conventional therapy and who require to counteract the pericardial inflammatory component rather than direct an acute viral injury to the pericardial tissue.
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spelling pubmed-85405662021-10-24 Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID? Carubbi, Francesco Alunno, Alessia Leone, Silvia Di Gregorio, Nicoletta Mancini, Bernardina Viscido, Angelo Del Pinto, Rita Cicogna, Sabrina Grassi, Davide Ferri, Claudio Viruses Article With the emerging success of the COVID-19 vaccination programs, the incidence of acute COVID-19 will decrease. However, given the high number of people who contracted SARS-CoV-2 infection and recovered, we will be faced with a significant number of patients with persistent symptoms even months after their COVID-19 infection. In this setting, long COVID and its cardiovascular manifestations, including pericarditis, need to become a top priority for healthcare systems as a new chronic disease process. Concerning the relationship between COVID-19 and pericardial diseases, pericarditis appears to be common in the acute infection but rare in the postacute period, while small pericardial effusions may be relatively common in the postacute period of COVID-19. Here, we reported a series of 7 patients developing pericarditis after a median of 20 days from clinical and virological recovery from SARS-CoV-2 infection. We excluded specific identifiable causes of pericarditis, hence we speculate that these cases can be contextualized within the clinical spectrum of long COVID. All our patients were treated with a combination of colchicine and either ASA or NSAIDs, but four of them did not achieve a clinical response. When switched to glucocorticoids, these four patients recovered with no recurrence during drug tapering. Based on this observation and on the latency of pericarditis occurrence (a median of 20 days after a negative nasopharyngeal swab), could be suggested that post-COVID pericarditis may be linked to ongoing inflammation sustained by the persistence of viral nucleic acid without virus replication in the pericardium. Therefore, glucocorticoids may be a suitable treatment option in patients not responding or intolerant to conventional therapy and who require to counteract the pericardial inflammatory component rather than direct an acute viral injury to the pericardial tissue. MDPI 2021-10-04 /pmc/articles/PMC8540566/ /pubmed/34696427 http://dx.doi.org/10.3390/v13101997 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Carubbi, Francesco
Alunno, Alessia
Leone, Silvia
Di Gregorio, Nicoletta
Mancini, Bernardina
Viscido, Angelo
Del Pinto, Rita
Cicogna, Sabrina
Grassi, Davide
Ferri, Claudio
Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?
title Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?
title_full Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?
title_fullStr Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?
title_full_unstemmed Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?
title_short Pericarditis after SARS-CoV-2 Infection: Another Pebble in the Mosaic of Long COVID?
title_sort pericarditis after sars-cov-2 infection: another pebble in the mosaic of long covid?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540566/
https://www.ncbi.nlm.nih.gov/pubmed/34696427
http://dx.doi.org/10.3390/v13101997
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