Приводится описание больной COVID-19 с развитием экссудативного перикардита, осложненного тампонадой сердца. Особенностью данного случая является наличие у пациентки фонового заболевания (хронический лимфолейкоз), которое в течение 1,5 лет находилось в фазе ремиссии после химиотерапии. Другой особенностью больной была относительно небольшая площадь поражения легких и геморрагический характер перикардиального выпота, который длительно сохранялся. Обращала на себя внимание незначительная активность воспалительных маркеров. В описании клинического наблюдения обсуждаются возможные механизмы развития и особенности течения экссудативного перикардита, вопросы диагностики и лечения данной категории пациентов.
Ключевые слова: новая коронавирусная инфекция, COVID-19, экссудативный перикардит, тампонада сердца
________________________________________________
A description of a COVID-19 patient with the development of exudative pericarditis complicated by cardiac tamponade is provid. A peculiarity of this case is the presence of an underlying disease in the patient (chronic lymphocytic leukemia), which was in remission for 1.5 years after chemotherapy. Another feature of the patient was the relatively small area of lung damage and the hemorrhagic nature of the pericardial effusion, which persisted for a long time. The insignificant activity of inflammatory markers was noteworthy. Possible mechanisms of development and features of the course of exudative pericarditis in the described patient, issues of diagnosis and treatment of this category of patients are discusse.
Keywords: new coronavirus infection, COVID-19, pericardial effusion, cardiac tamponade
1. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [published correction appears in JAMA. 2021;325(11):1113]. JAMA. 2020;323(11):1061-9. DOI:10.1001/jama.2020.1585
2. Bao C, Liu X, Zhang H, et al. Coronavirus disease (COVID-19) CT findings: a systematic review and meta-analysis. J Am Coll Radiol. 2020;17(6):701-9. DOI:10.1016/j.jacr.2020.03.006
3. Muhammad SZ, Ahmed A, Shahid I, et al. Chest computed tomography findings in hospitalized COVID-19 patients: a systematic review and meta-analysis. Infez Med.
2020;28(3):295-301. PMID:32920564
4. Diaz-Arocutipa C, Saucedo-Chinchay J, Imazio M. Pericarditis in patients with COVID-19: a systematic review. J Cardiovasc Med (Hagerstown). 2021;22(9):693-700. DOI:10.2459/JCM.0000000000001202
5. Li K, Wu J, Wu F, et al. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020;55(6):327-31. DOI:10.1097/RLI.0000000000000672
6. Farina A, Uccello G, Spreafico M, et al. SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade. Eur J Intern Med. 2020;76:100-1. DOI:10.1016/j.ejim.2020.04.045
7. Sauer F, Dagrenat C, Couppie P, et al. Pericardial effusion in patients with COVID-19: case series. Eur Heart J Case Rep. 2020;4(FI1):1-7. DOI:10.1093/ehjcr/ytaa287
8. Tong Y, Bao A, Chen H, et al. Necessity for detection of SARS-CoV-2 RNA in multiple types of specimens for the discharge of the patients with COVID-19. J Transl Med. 2020;18(1):411. DOI:10.1186/s12967-020-02580-w
9. Naqvi SGZ, Naseeb U, Fatima K, et al. Acute pericarditis and pericardial effusion in a hypertensive COVID-19 patient. Cureus. 2020;12(9):e10705. DOI:10.7759/cureus.10705
10. Walker C, Peyko V, Farrell C, et al. Pericardial effusion and cardiac tamponade requiring pericardial window in an otherwise healthy 30-year-old patient with COVID-19: a case report. J Med Case Rep. 2020;14(1):158. DOI:10.1186/s13256-020-02467-w
11. Hua A, O’Gallagher K, Sado D, Byrne J. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J. 2020;41(22):2130. DOI:10.1093/eurheartj/ehaa253
12. Dalen H, Holte E, Guldal AU, et al. Acute perimyocarditis with cardiac tamponade in COVID-19 infection without respiratory disease. BMJ Case Rep. 2020;13(8):e236218. DOI:10.1136/bcr-2020-236218
13. Dabbagh MF, Aurora L, D'Souza P, et al. Cardiac Tamponade Secondary to COVID-19. JACC Case Rep. 2020;2(9):1326-30. DOI:10.1016/j.jaccas.2020.04.009
14. Purohit R, Kanwal A, Pandit A, et al. Acute Myopericarditis with Pericardial Effusion and Cardiac Tamponade in a Patient with COVID-19. Am J Case Rep. 2020;21:e925554. DOI:10.12659/AJCR.925554
15. Asif T, Kassab K, Iskander F, Alyousef T. Acute pericarditis and cardiac tamponade in a patient with COVID-19: a therapeutic challenge. Eur J Case Rep Intern Med. 2020;7(6):00171. DOI:10.12890/2020_001701
16. Danilova OV, Danilov AV. Pericardial involvement by chronic lymphocytic leukemia/small lymphocytic lymphoma. Blood. 2015;126(3):424. DOI:10.1182/blood-2015-04-641571
17. Amoozgar B, Kaushal V, Mubashar U, et al. Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection: A case report. Medicine (Baltimore). 2020;99(37):e22093. DOI:10.1097/MD.0000000000022093
18. Johny D, Subramanyam K, Baikunje N, Hosmane GB. Cardiac tamponade and massive pleural effusion in a young COVID-19-positive adult. BMJ Case Rep. 2021;14(9):e244518. DOI:10.1136/bcr-2021-244518
19. Nainar R, Krishnan D, Kaliannan M, et al. An interesting paradox of COVID-19 illness in chronic lymphocytic leukemia. Indian Journal of Hematology and Blood Transfusion. 2020;36(Suppl. 1):S107-8.
________________________________________________
1. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [published correction appears in JAMA. 2021;325(11):1113]. JAMA. 2020;323(11):1061-9. DOI:10.1001/jama.2020.1585
2. Bao C, Liu X, Zhang H, et al. Coronavirus disease (COVID-19) CT findings: a systematic review and meta-analysis. J Am Coll Radiol. 2020;17(6):701-9. DOI:10.1016/j.jacr.2020.03.006
3. Muhammad SZ, Ahmed A, Shahid I, et al. Chest computed tomography findings in hospitalized COVID-19 patients: a systematic review and meta-analysis. Infez Med.
2020;28(3):295-301. PMID:32920564
4. Diaz-Arocutipa C, Saucedo-Chinchay J, Imazio M. Pericarditis in patients with COVID-19: a systematic review. J Cardiovasc Med (Hagerstown). 2021;22(9):693-700. DOI:10.2459/JCM.0000000000001202
5. Li K, Wu J, Wu F, et al. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020;55(6):327-31. DOI:10.1097/RLI.0000000000000672
6. Farina A, Uccello G, Spreafico M, et al. SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade. Eur J Intern Med. 2020;76:100-1. DOI:10.1016/j.ejim.2020.04.045
7. Sauer F, Dagrenat C, Couppie P, et al. Pericardial effusion in patients with COVID-19: case series. Eur Heart J Case Rep. 2020;4(FI1):1-7. DOI:10.1093/ehjcr/ytaa287
8. Tong Y, Bao A, Chen H, et al. Necessity for detection of SARS-CoV-2 RNA in multiple types of specimens for the discharge of the patients with COVID-19. J Transl Med. 2020;18(1):411. DOI:10.1186/s12967-020-02580-w
9. Naqvi SGZ, Naseeb U, Fatima K, et al. Acute pericarditis and pericardial effusion in a hypertensive COVID-19 patient. Cureus. 2020;12(9):e10705. DOI:10.7759/cureus.10705
10. Walker C, Peyko V, Farrell C, et al. Pericardial effusion and cardiac tamponade requiring pericardial window in an otherwise healthy 30-year-old patient with COVID-19: a case report. J Med Case Rep. 2020;14(1):158. DOI:10.1186/s13256-020-02467-w
11. Hua A, O’Gallagher K, Sado D, Byrne J. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J. 2020;41(22):2130. DOI:10.1093/eurheartj/ehaa253
12. Dalen H, Holte E, Guldal AU, et al. Acute perimyocarditis with cardiac tamponade in COVID-19 infection without respiratory disease. BMJ Case Rep. 2020;13(8):e236218. DOI:10.1136/bcr-2020-236218
13. Dabbagh MF, Aurora L, D'Souza P, et al. Cardiac Tamponade Secondary to COVID-19. JACC Case Rep. 2020;2(9):1326-30. DOI:10.1016/j.jaccas.2020.04.009
14. Purohit R, Kanwal A, Pandit A, et al. Acute Myopericarditis with Pericardial Effusion and Cardiac Tamponade in a Patient with COVID-19. Am J Case Rep. 2020;21:e925554. DOI:10.12659/AJCR.925554
15. Asif T, Kassab K, Iskander F, Alyousef T. Acute pericarditis and cardiac tamponade in a patient with COVID-19: a therapeutic challenge. Eur J Case Rep Intern Med. 2020;7(6):00171. DOI:10.12890/2020_001701
16. Danilova OV, Danilov AV. Pericardial involvement by chronic lymphocytic leukemia/small lymphocytic lymphoma. Blood. 2015;126(3):424. DOI:10.1182/blood-2015-04-641571
17. Amoozgar B, Kaushal V, Mubashar U, et al. Symptomatic pericardial effusion in the setting of asymptomatic COVID-19 infection: A case report. Medicine (Baltimore). 2020;99(37):e22093. DOI:10.1097/MD.0000000000022093
18. Johny D, Subramanyam K, Baikunje N, Hosmane GB. Cardiac tamponade and massive pleural effusion in a young COVID-19-positive adult. BMJ Case Rep. 2021;14(9):e244518. DOI:10.1136/bcr-2021-244518
19. Nainar R, Krishnan D, Kaliannan M, et al. An interesting paradox of COVID-19 illness in chronic lymphocytic leukemia. Indian Journal of Hematology and Blood Transfusion. 2020;36(Suppl. 1):S107-8.
1ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия; 2ГБУ «Городская клиническая больница им. С.С. Юдина» Департамента здравоохранения г. Москвы, Москва, Россия; 3ФГБУ «Федеральный научно-клинический центр физико-химической медицины им. акад. Ю.М. Лопухина» ФМБА России, Москва, Россия
*dvoretski@mail.ru
________________________________________________
Leonid I. Dvoretsky*1, Svetlana A. Rachina1, Maria G. Poltavskaya1, Denis A. Andreev1, Elena V. Tarykina2, Natalya A. Plaksina1, Vadim V. Minaev1, Angelina V. Terekhova3
1Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2Yudin City Clinical Hospital, Moscow, Russia; 3Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine, Moscow, Russia
*dvoretski@mail.ru