Pericardial Effusion Predicts Clinical Outcomes in Patients with COVID-19: A Nationwide Multicenter Study

Andreas Michael Bucher, Kristina Henzel, Hans Jonas Meyer, Constantin Ehrengut, Lukas Müller, Dominik Schramm, Alena Akinina, Michelle Drechsel, Roman Kloeckner, Peter Isfort, Marwin Jonathan Sähn, Matthias Fink, Dorottya More, Bohdan Melekh, Felix G. Meinel, Franziska Dreger, Matthias May, Lisa Siegler, Hanna Münzfeld, Richard RuppelTobias Penzkofer, Moon Sung Kim, Miriam Balzer, Jan Borggrefe, Alexey Surov*

*Corresponding author for this work


Rationale and Objectives: The prognostic role of pericardial effusion (PE) in Covid 19 is unclear. The aim of the present study was to estimate the prognostic role of PE in patients with Covid 19 in a large multicentre setting. Materials and Methods: This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the Covid 19 pandemic). The acquired sample comprises 1197 patients, 363 (30.3%) women and 834 (69.7%) men. In every case, chest computed tomography was analyzed for PE. Data about 30-day mortality, need for mechanical ventilation and need for intensive care unit (ICU) admission were collected. Data were evaluated by means of descriptive statistics. Group differences were calculated with Mann–Whitney test and Fisher exact test. Uni-and multivariable regression analyses were performed. Results: Overall, 46.4% of the patients were admitted to ICU, mechanical lung ventilation was performed in 26.6% and 30-day mortality was 24%. PE was identified in 159 patients (13.3%). The presence of PE was associated with 30-day mortality: HR = 1.54, CI 95% (1.05; 2.23), p = 0.02 (univariable analysis), and HR = 1.60, CI 95% (1.03; 2.48), p = 0.03 (multivariable analysis). Furthermore, density of PE was associated with the need for intubation (OR = 1.02, CI 95% (1.003; 1.05), p = 0.03) and the need for ICU admission (OR = 1.03, CI 95% (1.005; 1.05), p = 0.01) in univariable regression analysis. The presence of PE was associated with 30-day mortality in male patients, HR = 1.56, CI 95%(1.01–2.43), p = 0.04 (multivariable analysis). In female patients, none of PE values predicted clinical outcomes. Conclusion: The prevalence of PE in Covid 19 is 13.3%. PE is an independent predictor of 30-day mortality in male patients with Covid 19. In female patients, PE plays no predictive role.

Original languageEnglish
JournalAcademic Radiology
Issue number5
Pages (from-to)1784-1791
Number of pages8
Publication statusPublished - 05.2024


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