Background: Coronavirus disease 2019 (COVID-19) infection can involve the cardiovascular system with many presentations, including pericardial effusion. Nevertheless, there is no evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detected in pericardial effusion during the acute phase of COVID-19 infection. Case Presentation: We report an acute, large but located pericardial effusion during acute COVID-19 infection, which required emergent pericardiocentesis. SARS-CoV-2 RNA was found in the pericardial fluid. The patient also presented with concomitant pleural and peritoneal effusion. The patient was treated with colchicine and was discharged 16 days later. Conclusion: SARS-CoV-2 RNA can be detected in pericardial effusion during the acute phase of COVID-19 infection. Concomitant presence of pleural and peritoneal effusion could confirm the hypothesis of exaggerated systemic inflammatory response triggered by the virus.

Keywords: COVID-19, cardiac tamponade, pericardial effusion, polyserositis