Novel Coronavirus Disease in most cases produces mild symptoms which resolve after a few days. Some authors hypothesized that SARS-CoV-2 infection could trigger excessive cytokine production leading to a severe multi-organ disease requiring intensive care admission. Respiratory and neurological symptoms are the most frequently reported manifestation of the disease. Indeed, cardiac involvement is reported mostly as a part of a systemic disease. Few isolated cardiac manifestations of COVID-19 infection have been described. We report herein a case of SARS-CoV-2 related severe isolated pericardial involvement requiring ICU admission due to cardiac tamponade needing urgent drainage. Analysis of pericardial fluid from drainage demonstrated a higher cytokine concentration than blood values. Other causes of pericardial disease, such as autoimmunity, bacterial or other than COVID-19 infection, neoplasms or acute myocardial infarction were also evaluated, but all tests confirmed negative results. The suspicion of isolated involvement of the pericardium was therefore demonstrated by the analysis of cytokines which strongly support our hypothesis.

在大多数情况下，新型冠状病毒病会产生轻微的症状，几天后就会消失。一些作者假设 SARS-CoV-2 感染可能引发细胞因子过度产生，导致严重的多器官疾病，需要入院重症监护。呼吸系统和神经系统症状是该疾病最常报道的表现。事实上，据报道，心脏受累大多是全身性疾病的一部分。很少有关于 COVID-19 感染的孤立心脏表现的描述。我们在此报告一例 SARS-CoV-2 相关的严重孤立性心包受累，由于心脏压塞需要紧急引流，需要入住 ICU。对引流心包液的分析表明，细胞因子浓度高于血液值。还评估了心包疾病的其他原因，例如自身免疫、细菌或除 COVID-19 以外的感染、肿瘤或急性心肌梗死，但所有测试均证实结果为阴性。因此，细胞因子的分析证明了心包孤立受累的怀疑，这有力地支持了我们的假设。