Coronavirus disease 2019 (Covid-19) presenting as purulent fulminant myopericarditis and cardiac tamponade: A case report and literature review.
Akshay Khatri, Frances Wallach
PMID 32693958WHAT IT FOUND
A 50-year-old man with confirmed SARS-CoV-2 infection developed purulent fulminant myopericarditis and cardiac tamponade, then shock and died on hospital day four.
This case cannot prove treatment worked.
Key findings
01The working diagnosis was SARS-CoV-2 infection causing purulent myopericarditis, cardiogenic and distributive shock, and multi-organ failure, with echocardiographic evidence of tamponade physiology.
02Pericardiocentesis drained 600cc of serosanguinous fluid, and post-procedure echocardiography showed moderate improvement in hemodynamic parameters.
03He died on hospital day four from multi-organ failure despite maximal vasopressor support and supportive care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a case report, so it cannot establish that SARS-CoV-2 caused the myopericarditis or that any treatment worked. The patient received several treatments at the same time, so the contribution of any component cannot be separated. The literature review compares other case reports, not controlled studies. The exact mechanism of SARS-CoV-2-induced cardiac injury is not known.
Declared interests
The authors declared no pertinent conflicts of interest.
The easy way to misread this
Do not conclude that any treatment improved survival. The patient received mechanical ventilation, pericardiocentesis, vasopressors, inotropes, antibiotics, hydroxychloroquine, IVIG, methylprednisolone, and methylene blue together. The contribution of any single component cannot be separated.