Successful Management of COVID-19-Associated Systemic Capillary Leak Syndrome Using Veno-Venous Extracorporeal...

Systemic capillary leak syndrome (SCLS) is a rare and life-threatening disorder characterized by acute hypotension, hypoalbuminemia, and hemoconcentration, which often results in severe respiratory complications, such as pulmonary edema. SCLS can be triggered by infections, including COVID-19, and is associated with a high mortality rate. Here, we report a case of COVID-19-associated SCLS in a 68-year-old man. After aggressive fluid resuscitation, the patient's respiratory failure worsened. Veno-venous extracorporeal membrane oxygenation (V-V ECMO) was initiated early because of rapidly declining oxygenation (PaO₂/FiO₂=58) and pulmonary compromise. V-V ECMO successfully supported respiratory and circulatory functions and stabilized the patient. The patient was successfully weaned from ECMO on day 10 and later discharged from the ICU in stable condition. This case highlights the potential benefits of early ECMO intervention and controlled fluid resuscitation in managing COVID-19-associated SCLS.