Delayed Presentation of SARS-CoV-2–Related Pericarditis in a Professional Soccer Player: A Case Report

Abstract

BACKGROUND: Pulmonary and extrapulmonary manifestations may accompany SARS-CoV-2 infection. Myocarditis and pericarditis are the most common cardiovascular complications after SARS-CoV-2 infection. Pericarditis, a common cause of cardiac chest pain, results from inflammation of the pericardium, commonly caused by a viral infection. It may be misinterpreted as nonspecific musculoskeletal pain. CASE PRESENTATION: A 27-year-old professional soccer player who tested positive for SARS-CoV-2 was admitted to the hospital with dyspnea and fever and ultimately diagnosed with right interstitial pneumonia. He gradually returned to play, after negative cardiac examinations. However, 40 days after a postinfection negative viral test, he experienced new onset mild chest pain. A physical assessment revealed musculoskeletal pain, and myofascial treatments were undertaken the day after. After 17 days without symptoms, the athlete suffered from worsening chest pain. He underwent a cardiac examination that confirmed the clinical suspicion of pericarditis, despite the previous negative cardiac examinations. TREATMENT AND FOLLOW-UP: The athlete was temporarily disqualified from training and competitions, and pharmacological therapy was started. After the resolution of symptoms and pericardial effusion, the athlete gradually returned to play without any sequelae. DISCUSSION: The diagnosis of pericarditis is sometimes delayed because of the misinterpretation of its symptoms. This case report highlights the importance of a comprehensive clinical assessment and the benefits of multidisciplinary management, particularly during the COVID-19 era, to diagnose pericarditis even if an athlete has recently been screened. JOSPT Cases 2022;2(4):255–261. Epub: 17 October 2022. doi:10.2519/josptcases.2022.11117