Fatal Exacerbations of Systemic Capillary Leak Syndrome Complicating Coronavirus Disease

Emerg Infect Dis. 2021 Oct;27(10):2529-2534. doi: 10.3201/eid2710.211155. Epub 2021 Jul 27.


We report 2 fatal exacerbations of systemic capillary leak syndrome (SCLS), also known as Clarkson disease, associated with coronavirus disease (COVID-19) in the United States. One patient carried an established diagnosis of SCLS and the other sought treatment for new-onset hypotensive shock, hemoconcentration, and anasarca, classic symptoms indicative of an SCLS flare. Both patients had only mild-to-moderate symptoms of COVID-19. This clinical picture suggests that these patients succumbed to complications of SCLS induced by infection with severe acute respiratory syndrome coronavirus 2. Persons with known or suspected SCLS may be at increased risk for developing a disease flare in the setting of mild-to-moderate COVID-19 infection.

Keywords: COVID-19; Clarkson disease; SARS-COV-2; capillary leaks; coronavirus disease; multiple organ failure; respiratory infections; severe acute respiratory syndrome coronavirus 2; systemic capillary leak syndrome; viruses.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • COVID-19*
  • Capillary Leak Syndrome* / diagnosis
  • Capillary Leak Syndrome* / etiology
  • Humans
  • SARS-CoV-2
  • United States