From the Guidelines
Among the viruses listed, the influenza virus is most likely to cause pericarditis, as it is one of the various viruses known to cause pericarditis, including enteroviral, adenoviral, and others, as stated in the guidelines on the diagnosis and management of pericardial diseases 1. The diagnosis of viral pericarditis is not possible without the evaluation of pericardial effusion and/or pericardial/epicardial tissue, preferably by PCR or in-situ hybridisation, and a four-fold rise in serum antibody levels is suggestive but not diagnostic for viral pericarditis 1. Some key points to consider when evaluating the likelihood of a virus causing pericarditis include:
- The type of virus: enteroviruses, such as Coxsackie virus, are known to cause pericarditis, especially during seasonal epidemics 1
- The patient's immune status: immunocompromised patients, such as those with HIV, are more susceptible to certain viral infections, including cytomegalovirus pericarditis 1
- The clinical presentation: patients with viral pericarditis may present with chest pain, fever, and a friction rub heard on cardiac examination Treatment of viral pericarditis is directed to resolve symptoms, prevent complications, and eradicate the virus, and may involve anti-inflammatory medications, such as NSAIDs or colchicine, with more severe cases potentially requiring corticosteroids or other immunomodulatory therapies.
From the Research
Virus Causing Pericarditis
The most likely virus to cause pericarditis among the given options is the coronavirus. This is based on several studies that have reported cases of pericarditis in patients with COVID-19, a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 2, 3, 4, 5, 6.
Key Findings
- Pericarditis has been reported as a common extrapulmonary manifestation of COVID-19 2.
- The incidence of pericarditis is more common in males, with a male-to-female ratio of 2:1 2.
- Symptoms of pericarditis in COVID-19 patients include chest pain, fever, shortness of breath, cough, fatigue, myalgia, and diarrhea 2, 4.
- Laboratory tests have revealed leukocytosis with neutrophil predominance, elevated D-dimer, erythrocyte rate, and C-reactive protein in patients with COVID-19 pericarditis 2.
- Treatment with colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids has been effective in managing pericarditis in COVID-19 patients 2, 3, 4, 5, 6.
Comparison with Other Viruses
There is limited evidence to suggest that influenza (flu) virus, paramyxovirus, or Togavirus are commonly associated with pericarditis. While these viruses can cause various respiratory and systemic illnesses, the current evidence does not support a strong link between these viruses and pericarditis 2, 3, 4, 5, 6.