What are the symptoms and treatment options for post-COVID-19 pericarditis (inflammation of the pericardium)?

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Last updated: February 7, 2025View editorial policy

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From the Guidelines

Post-COVID-19 pericarditis is a condition characterized by inflammation of the pericardium, which can cause symptoms such as chest pain, electrocardiographic changes, and pericardial effusion.

Symptoms of Post-COVID-19 Pericarditis

  • Chest pain
  • Electrocardiographic changes
  • Pericardial effusion
  • Palpitations
  • Signs and symptoms of heart failure

Treatment Options for Post-COVID-19 Pericarditis

  • Transthoracic echocardiography (TTE) is the first-line imaging modality for evaluating pericardial pathology 1
  • Cardiac MRI may be performed on a case-by-case basis with a specific clinical question in mind, such as athletes returning to physical activity 1
  • Treatment should be based on symptoms, and further investigation for cardiac abnormalities should be performed according to symptoms in patients presenting with cardiac symptoms 1
  • There is no specific treatment recommended for post-COVID-19 pericarditis, but it is essential to monitor patients with persistent symptoms suggestive of perimyocardial injury 1
  • A repeat TTE may be performed at 2 to 3 months for patients who had cardiac abnormalities during acute disease (myocarditis, pericarditis, heart failure) 1

From the Research

Symptoms of Post-COVID-19 Pericarditis

  • Chest pain (60%) 2
  • Fever (51%) 2
  • Shortness of breath (51%) 2
  • Cough (39%) 2
  • Fatigue (15%) 2
  • Myalgia (12%) 2
  • Diarrhea (12%) 2
  • Leukocytosis with neutrophil predominance, elevated D-dimer, erythrocyte rate, and C-reactive protein 2
  • Elevated cardiac markers including troponin-1, troponin-T, and brain natriuretic peptide 2

Treatment Options for Post-COVID-19 Pericarditis

  • Colchicine 2, 3, 4
  • Non-steroidal anti-inflammatory drugs (NSAIDs) 2, 3, 4, 5
  • Corticosteroids 2, 5
  • Interventional therapy (only needed when patient develops cardiac tamponade) 2
  • Therapeutic pericardiocentesis (for significant pericardial effusion and tamponade) 5

Diagnostic Methods

  • Electrocardiography (ECG) 2, 4
  • Echocardiogram 2, 4
  • Radiographic imaging of the chest 2
  • Laboratory tests (including complete blood count, C-reactive protein, and cardiac markers) 2, 4

Clinical Features and Outcomes

  • Pericarditis can occur as a late complication of COVID-19, even after apparent resolution of the acute infection 3, 6
  • The majority of patients with COVID-19-related pericarditis recover or do not experience continued clinical deterioration 2, 4
  • In-hospital mortality is relatively low (6%) 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Pericarditis in patients with COVID-19: a systematic review.

Journal of cardiovascular medicine (Hagerstown, Md.), 2021

Research

Myocarditis and Pericarditis in Patients with COVID-19.

Heart views : the official journal of the Gulf Heart Association, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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