P306 COVID–19 RELATED PERICARDITIS. CLINICAL IMPLICATIONS AND ROLE OF CARDIAC REHABILITATION IN SUBSEQUENT LONG–COVID SYNDROME

Abstract

Acute pericarditis is considered one of the cardiovascular complications of COVID–19.Aim of the StudyThe aim was to evaluate the prevalence and clinical implications of acute pericarditis diagnosed through the presence of pericardial effusion in patients with COVID–19.MethodsThe investigation is a retrospective observational study enrolling patients admitted to ICU of Madonna del Soccorso Hospital (San Benedetto del Tronto, Italy) because of a SARS–Cov2 induced severe acute respiratory syndrome. N.170 patients, admitted from 1st april 2020 to 30th april 2021, were enrolled. All patients presented a variable picture of bilateral ground glass opacifications at HR– Chest CT. Some patients underwent oro–tracheal intubation+invasive ventilation. All patients underwent cardiological consultation including a transthoracic bedside echocardiogram, using ultrasound E9–GE machine (Boston, MA, USA). Demographic, laboratory and clinical data were collected for all enrolled patients.The diagnosis of acute pericarditis was defined by different degrees of pericardial effusion. All patient were divided in two groups: 1) pericarditis group (A); 2) pericarditis–free group (B).ResultsOf 170 enrolled patient, 51 were females (30%) and 119 were males (70%). Median age for all patients was 67,6 + 13,3 (females: 70,5 + 16,2; males: 66,4 + 11,7). Of 170, n. 60 patients had a diagnosis of acute pericarditis (32,2%) and were included into Group A [age 69,2 + 12,6; 39 (65%) males aged 69,3 + 10,6, 21 (35%) females aged 69,1 + 16,0]. Of 60, only 6 had a pericardial effusion >10 mm (10%); the remaining group A–patients (90%) had a mild pericardial effusion (<10 mm). No patient had tamponade picture. Group B (pericarditis–free) included 110 patients, aged 66,7 + 13,7, 80 (72,7%) males aged 65,0 + 12,1, 30 (27,3%) females aged 71,4 + 16,6. Group A–patients had more days of intubation and a prolonged hospital stay compared with group B, with a significant difference (p < 0.02 and p < 0,03 rispectively). N. 21 of 60 group A patients underwent a 7 weeks of CARDIAC REHABILITATION (CR) because of a LONG–COVID picture. In these patient a 6MWT was performed before and after CR. A significant increase of the walked distance after CR was found (from 352 + 21 to 498 + 31 – p < 0.03 – delta=41%).ConclusionPericarditis is a frequent cardiovascular complication of COVID–19 (32,2% in our study) with clinical and prognostic implications. CR is essential for long–term recovery in these patients.