Is COVID-19 One of the Causes of Pleurisy?

Pneumonia caused by COVID-19, which induces inflammation of the pleura, can lead to pleurisy. Both COVID-19 and pleurisy are severe medical conditions.

Pleurisy, also known as pleuritis, is a condition in which the two layers of tissue — the pleura — that surround your lungs become inflamed. Pleuritis is caused by viral or bacterial infections within the pleura. The novel coronavirus is a viral infection of the lungs that can cause pneumonia, lung inflammation, and another bacterial infection in your lungs.

Pneumonia caused by COVID-19, which induces inflammation of the pleura, can lead to pleurisy. Both COVID-19 and pleurisy are severe medical conditions. It’s essential to know the symptoms of both, so that you can get medical attention immediately.

A condition of the respiratory system, pleurisy affects your lungs' ability to extract enough oxygen from the air, which can cause the following symptoms:

• Pain in the chest when you breathe
• Fever and headache
• Difficulty breathing
• Rapid breathing
• Muscle aches
• Coughing

The chest pain experienced with pleurisy is commonly described as a stabbing pain that worsens as you breathe. Pain might be felt in your shoulders or back and may worsen as you move around. If a viral infection is the cause, symptoms can include fever, headaches, and muscle aches. These symptoms may not be present if you have a bacterial infection. 

COVID-19 causes conditions that can lead to the development of pleurisy. Symptoms of COVID-19 are similar to those listed for pleurisy, plus:

• Pain or pressure in your chest 
• Muscle and body aches
• Nausea and vomiting
• Bluish lips and face
• Trouble breathing
• Fever and chills
• Confusion
• Headache
• Fatigue
• Diarrhea

The pleura is a two-layer tissue sack (or membrane) that surrounds your lungs. The inner layer is called the visceral layer, and the outer layer is called the parietal layer. As you breathe, the two layers move against each other. In between the layers is a space called the pleural cavity. The cavity is filled with less than a teaspoon of lubricating fluid that allows the two layers to glide over each other when you're breathing.

If the pleura becomes inflamed, the inner and outer layers swell and rub against each other. This causes the chest pain you feel when you breathe. An inflamed pleura can also lead to a condition where the body sends more fluid to the pleural cavity, called pleural effusion.  

The pleura can become inflamed for various reasons, but most commonly it’s caused by a viral infection. Other causes of pleurisy include:

• Bacterial infection of the lower respiratory system
• Pulmonary embolism (a blood clot in your lungs)
• Chest injuries that damage the pleura
• Air leaking from a hole in the lung
• Rheumatoid arthritis
• Sickle cell anemia
• Pancreatitis
• Pneumonia
• Lupus

While the novel coronavirus and pleurisy display similar symptoms, there’s no hard evidence showing that COVID-19 directly causes pleurisy. However, COVID-19 can cause conditions that can lead to pleurisy, such as pneumonia, pulmonary embolism (a blood clot in the arteries in your lungs), and respiratory infections. COVID-19 can also aggravate existing conditions.

If you're experiencing pleurisy or coronavirus symptoms, seek medical attention immediately.

Your doctor will conduct a physical exam and discuss your symptoms with you. Doctors use chest x-rays or CT scans to look at your pleura, lungs, and chest area for any other conditions that have symptoms similar to COVID-19 or pleurisy. 

They may also do a blood test to check your white and red blood cell counts, indicating whether you have an infection. As a last resort, your doctor may remove some of the fluid from your pleura with a needle for testing.

If your doctor finds a bacterial infection in your pleura, they may prescribe antibiotics to fight the infection. If you have a viral infection in your pleura, the doctor may prescribe acetaminophen (Tylenol) or ibuprofen to help with the pain and swelling.

If you have pleural effusion, you may need surgery to drain the fluid from around your lungs.