PMC:7546120 / 2682-4850 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7546120","sourcedb":"PMC","sourceid":"7546120","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7546120","text":"Discussion\nTo our knowledge, this is a novel description of COVID-19 related pleural effusion describing the pleural fluid analysis of virus detection confirmed by RT-PCR and behaving as a complicated parapneumonic effusion. There is a paucity of data describing the pleural complications in relation to the viral infections in general. A prior study by Cohen and Sahn,1 reported an 8% incidence of pleural effusions in patients with acute viral infection, while using lateral decubitus chest X-rays incidence is reported to be 18%. However, the true incidence of viral related pleural effusion may be even higher if pleural ultrasonography is used as a screening tool for pleural fluid presence. In a review by Nestor et al., 2 the pleural fluid analysis in viral related pleural effusion is variable and typically exudative. Pleural fluid appearance can range from serous, serosanguineous, to hemorrhagic.\nWith respect to the SARS-CoV-2 pneumonia, review of literature reveals the prevalence of pleural effusion can be as high as 14% in patients.3–5 In one of the largest trials, Li et al.3 described intrathoracic lymph node enlargement in 67% of cases and pleural effusion in 14% of cases. Patients with more severe cases have a higher prevalence of both lymphadenopathy and pleural effusions.3–5\nPleural fluid analysis in this case showed an exudative effusion with high lymphocyte count. Even though pleural fluid analysis is rarely diagnostic in isolation, the differential diagnosis of a lymphocytic, exudative pleural effusion is broad and would include viral related pleural effusions. In our case, SARS-CoV-2 RNA was detected using RT-PCR, which is consistent with the diagnosis of a complicated parapneumonic effusion from SARS-CoV-2 related pneumonia.\nConflict of interest. None declared.\nFigure 1. An axial image of a contrasted chest computed tomography (CT) at the level of the bifurcation of the main pulmonary artery and at the level of the hilum. The chest CT demonstrates a large, left-sided, non-complex pleural effusion. There are pathologically enlarged lymph nodes, defined by \u003e1 cm in short axis, located in the sub-carinal and hilar 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