Post-COVID-19 sequela: Massive tubercular pericardial effusion in immunocompromised patient

G. Kumar, Lakhan Parajiya, S. Avinash Pandi, V. Patel
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Abstract

Long-term sequelae following COVID-19 infection are not well established. Hence, COVID-19 sequelae are been studied extensively as cases are being followed up to reduce avoidable prolonged morbidity and mortality in the country. COVID-19 and currently available drugs for treatment are both reasons for a change in immune status of patients leading to reactivation or increase the chance of infection of common diseases like tuberculosis (TB), particularly in India. A case of post-COVID-19 disease (2 months back) presented with breathlessness and chest pain. On history, workup, and evaluation, the case was diagnosed with massive tubercular pericardial effusion suggesting reactivation of latent TB in a post-COVID-19 disease. Due to COVID-19 disease itself and possible immunomodulatory drugs used for treatment, reactivation of latent TB has to be considered in post-COIVD-19 disease with nonspecific presentation and unexplained prolonged clinical course of the disease. This case highlights the need of further follow-up of COVID-19 patients to understand the effects of disease on the immune system and the possibilities of opportunistic infections, especially after this second wave of COVID-19.
covid -19后后遗症:免疫功能低下患者大量结核性心包积液
COVID-19感染后的长期后遗症尚不清楚。因此,在对病例进行随访的同时,对COVID-19后遗症进行了广泛研究,以减少该国可避免的长期发病率和死亡率。COVID-19和目前可用的治疗药物都是导致患者免疫状态改变的原因,导致结核病等常见疾病的重新激活或感染机会增加,特别是在印度。1例covid -19后疾病(2个月前)出现呼吸困难和胸痛。根据病史、检查和评估,该病例被诊断为大量结核性心包积液,提示在covid -19后疾病中潜伏性结核的再激活。由于COVID-19疾病本身以及治疗中可能使用的免疫调节药物,在具有非特异性表现和不明原因的临床病程延长的COVID-19后疾病中,必须考虑潜伏性结核病的再激活。该病例强调需要对COVID-19患者进行进一步随访,以了解疾病对免疫系统的影响和机会性感染的可能性,特别是在第二波COVID-19之后。
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