Pulmonary Capillary Leak Syndrome following COVID‐19 Virus Infection

Bahloul, Mabrouk; Ketata, Wajdi; Lahyeni, Dorra; Mayoufi, Houda; Kotti, Amina; Smaoui, Fatma; Kallel, Nessrine; Daoud, Emna; Bouaziz, Mounir; Kammoun, Samy

Pulmonary capillary leak syndrome secondary to influenza SARS‐CoV‐2virus infection was not previously reported. We report 2 cases. The diagnosis of non‐cardiogenic pulmonary edema due to pulmonary capillary leak syndrome SARS‐CoV‐2 virus infection was obtained by a medical committee of 6 physicians. The diagnosis of COVID‐19 infection is confirmed by reverse transcription polymerase chain reaction (RT‐PCR) test. Moreover, in this specific endemic situation, and according to the British Society of Thoracic Imaging expert reference group update, we took account of chest CT‐Scan results in the early detection of COVID‐19 pneumonia. Our 2 patients with a confirmed influenza SARS‐CoV‐2virus infection had respiratory distress with lung crackles on auscultation of one or both lungs and with alveolar pulmonary edema on the chest CT‐Scan. The cardiogenic nature of pulmonary edema was ruled out in both cases by a transthoracic echocardiography showing normal systolic and diastolic functions. Our patients were treated by oxygen via face mask in one case and mechanical ventilation as supportive treatment in the other patient. Hydroxychloroquine (600mg/day), Azithromycine, steroids (dexamethasone 20mg/day), vitamin C (3g/day), Zinc, diuretics and Enoxaparine were equally used for the two patients. Evolution was marked by a good outcome in both of them. In summary, acute respiratory failure is a rare but major complication of COVID‐19 virus infection. It is due to pulmonary capillary leak syndrome. Treatment is based on a good oxygenation, intravenous corticosteroids, diuretics, Azithromycine, vitamin C, and other symptomatic treatments. This article is protected by copyright. All rights reserved.