Successful Management of Systemic Capillary Leak Syndrome Secondary to Coronavirus Disease 2019 Mimicking the Course of Fulminant Myocarditis by Venous-arterial Extracorporeal Membrane Oxygenation: A Case Report

Intern Med. 2025 Jan 3. doi: 10.2169/internalmedicine.4677-24. Online ahead of print.

Abstract

We herein report a case of Systemic Capillary Leak Syndrome (SCLS) attributed to coronavirus disease (COVID-19) that emerged in 2019. A 56-year-old woman presented with a COVID-19 infection 7 days prior to the visit with upper respiratory symptoms, fatigue, and decreased appetite. Secondary SCLS due to COVID-19 was diagnosed, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated as mechanical support, and intravenous immunoglobulin was administered, marking the transition to the recovery phase with the initiation of fluid resuscitation. This case is noteworthy for successfully employing VA-ECMO in treating secondary SCLS due to COVID-19, mimicking the course of fulminant myocarditis.

Keywords: COVID-19; Fulminant Myocarditis; Intravenous Immunoglobulin (IVIg); Secondary SCLS; Systemic Capillary Leak Syndrome (SCLS); Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO).