Constrictive Pericarditis Associated with COVID-19 or Vaccination

Pericarditis and myocarditis have been increasingly associated with coronavirus disease-2019 (COVID-19) infection or vaccination, although the occurrence of the voluminous pericardial effusion or constrictive pericarditis (CP) is exceedingly rare.[1][2][3][4][5][6][7] Up to 49% of CPs result from idiopathic or viral pericarditis; up to 37% are postsurgical; up to 31% are postradiotherapy; up to 7% are due to connective tissue disorders; and up to 6% from tuberculosis.7 The inner non-compliant layer restricts the maximal volume of the heart and can impede the diastolic function; the treatment is typically symptomatic, except in severe effusive cases that require pericardium removal.[1][2][3][4][5][6][7] The recent case study published by Kaya and Yalta 4 has drawn our attention to the association between COVID-19 infection or vaccination, and manifestations of relatively severe pericardial involvement.The 33-year-old, previously healthy male patient presented with cardiac manifestations five months after receiving the third dose of the mRNA-BioNTech vaccine and four months following the COVID-19 diagnosis.4 Cardiological examination involving imaging modalities such as echocardiography, magnetic resonance imaging, and cardiac catheterization established the diagnosis of CP related either to COVID-19 infection or vaccination.4 The patient urgently underwent planned pericardiectomy, and the postoperative course was uneventful.Therefore, the following brief remarks regarding additional literature data aim to underscore their contributions.