Acute Pericarditis as the Primary Presentation of COVID-19 Infection followed by Guillain-Barre Syndrome in a Healthy Young Man: A Case Report

Giti Noghabaei1, Maliheh Arab2 , *, Sara Payami3, Behnaz Ghavami4
1 Iran University of Medical Science, Tehran, Iran
2 Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Emergency Department, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
4 Fellowship of Laparoscopy, Tehran University of Medical Sciences, Tehran, Iran

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© 2022 Noghabaei et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
Tel: +982177553112; Fax: +982177543634; E-mail:



Symptomatic COVID-19 infection most often presents as acute respiratory distress syndrome. Acute pericarditis and Guillain–Barré syndrome are rare extrapulmonary manifestations of this infection.

Case Presentation:

A 27-year-old man presented with chest pain, with negative troponin and typical electrocardiographic findings, resulting in a diagnosis of acute pericarditis. He had no respiratory symptoms, nor the chest computerized tomography (CT) scan findings of COVID-19, and his Polymerase chain reaction (PCR) was negative. One week later, he developed clinical symptoms of Guillain-Barre syndrome, along with respiratory manifestations of COVID-19. His repeat chest CT scan and PCR test confirmed COVID-19 infection. After 17 days of hospital stay, he improved clinically and was discharged.


This is the first case of acute pericarditis as the primary presentation of COVID-19 in the absence of respiratory symptoms and a clear chest CT scan, followed by the development of Guillain–Barré syndrome and respiratory tract manifestations of COVID-19. Clinicians should be aware of the extrapulmonary presentation of COVID-19 infection.

Keywords: Acute pericarditis, Guillain–Barré syndrome, CT scan, Respiratory infection, Cardiovascular complications, COVID-19.