Systemic capillary leak syndrome and myositis secondary to SARS-Cov-2 in a

child, a case report

Saad Alotaibi, Walid Hassan, Ahmad Alhaj, Mohamed Hajaj, Aymen Elghandor, Ahmed Abdelmonem, Hashem Alhashemi.
Pediatrics department, PICU, Farwaniya hospital, Kuwait...

Methodology Results Conclusion

Abstract
He presented with 4 days history of generalized body pain, sought medical advice in
polyclinic ,received antihistaminic,antipyretic and spasmolytic. However the condition not
CMV and EBV pcr were negative This is the first reported case of systemic capillary leak syndrome
improved, then came to Er next day with abdominal pain ,vomiting ,received IVF and Echo heart revealed minimal pericardial effusion did not need and myositis associated with COVID-19 infection in children. He
antiemetic then improved and discharged home.Next day came to Er again with pericardiocentesis. EF normal at 59% developed the classic features of myositis and systemic capillary
generalized body pain more in LL with unsteady gait, according to ER exam there was
areflexia in lower limbs and upper limb was normal tone and reflexes,GCS 15/15
His Urea 3.3 , Creat 31, Na 129, K 5.4 leak syndrome secondary to SARS-Cov-2, these are dysfunctional
Patient was admitted to ward he was alert ,conscious, responsive ,no signs of meningeal ALT 230, AST 587, INR 0.9, PT 10, PTT 20 endothelial inflammatory response ,extravasation of fluid from the
irritation, bil reactive pupils, Normal BP, maintaning spo2 on RA. His U/S abdomen showed Hepatomegaly due to edema He had one vascular space to the interstitial space leading to shock,
Patient was shifted picu due to rapid deterioration in view of disturbed conscious level,
tachycardia ,poor perfusion ,mottling , so patient was intubated and connected to MV.
spike of fever 38 and started on ceftriaxone all his cultures negative. hemoconcentration, hypoalbuminemia, and subsequent organ
failure.
Started on IVIG 2pm/kg over 2 days and pulse steroids 30 mg/kg for 3 days Virology studies positive for COV 19 only.
Sedation with fenanyl and precedex Inotrope with epinephrine 0.1
Excellent response to IVIG and Pulse steroids and child improved
Mechanical ventilation simv FiO2 35, peep 7, Tv 160, rate 25 Cbc. Wbc 21, N 81%, Hb 159, PLT 312 , CRP 16, PCT 0.2 , troponin clinically with no sequele
336, CK > 44000 , ferritin 97, lactate (5) , LDH more than 750H
He had respiratory acidosis PCO2 reached 7.5
Edema was generalized with fluid balance +2000 first day he has normal renal function
and his urine output 2 ml/kg on furosemide

Introduction

a case report 6 years old boy admitted to picu as

acase of covid+ve ,inflammatory myositis with
. myoglobinurea.. This is the first case report of
SRAS-COV-2 causing Inflamtory myositis and
capillary elk syndrome in children.

Acknowledgements