ABSTRACT
Protective, sustainable and long-lasting immunity following COVID-19 infection is uncertain, and the potential mechanisms that mediate it are not yet fully understood. We reported a case of a COVID-19 positive 53-year-old female with a medical history of hypertension, vaccination for COVID-19 in July 2021 and paucisymptomatic COVID-19 infection two months later, presented to the ED for an acute uneasy sensation over the posterior left side of the chest with radiation to left arm and shoulder of short duration and a nonproductive worsening cough in the last days. The patient's vital signs were notable for an oxygen saturation of 94% in RT and oxygen therapy was started. An ECG demonstrated sinus tachycardia with diffuse ST elevations. TC pulmonary scan showed a normal parenchimal density and a pericardial effusion. A TTE confermed small pericardial effusion and normal systolic function. CRP, myoglobin, CK-MB and troponin were within the normal values. The anti-spike antibodies were positive and no monoclonal antibody therapy could be performed. She also developed a diarrhea with negative coprocolture and parasitological stool exam. For pericarditis management, high dose steroidal drugs were started. Her symptoms improved rapidily. She was discharged 7 days after the admission. Unfortunately genomic analysis was not available in both episodes and it remains unclear whether they were caused by different strains. Given increased symptom severity during reinfection, our case highlights the need to monitor these patients more closely on a short-term and long-term basis.