Objective: Systemic capillary leak syndrome (SCLS) is a severe condition characterized by the coexistence of hypovolaemic shock, haemococentration, and hypoalbuminaemia, without albuminuria, that may progress to multiorgan failure and an unfavourable outcome. Its development is often triggered by viral infections, such as influenza A virus, but it is unclear whether it is also triggered by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We aimed to investigated the association between SARS-CoV-2 and SCLS.

Method: We present the case of a 55-year-old-woman affected by SARS-CoV-2 infection who developed SCLS. Moreover, we performed a systematic review of the literature to identify any common features with other cases and to describe clinical characteristics and outcomes.

Results: We found three other cases of SCLS occurring during SARS-CoV-2 infection in 2020. Taking all cases together, the mean age was 50 years (range 38–63), with a 1:1 gender ratio. Respiratory manifestations were the most common symptom, and all patients required admission to the intensive care unit. The mortality rate was 50%.

Conclusions: SARS-CoV-2 infection may trigger SCLS disease, either by an overproduction of proinflammatory cytokines or by direct viral infection of the endothelium. Since SCLS may have a poor prognosis, in every SARS-CoV-2-infected patient presenting the suggestive triad of hypovolaemic shock, haemoconcentration, and hypoproteinaemia, an SCLS diagnosis should be considered and early treatment initiated.

目的：系统性毛细血管渗漏综合征 (SCLS) 是一种严重的疾病，其特征是低血容量性休克、血液浓缩和低白蛋白血症并存，但没有白蛋白尿，可能会发展为多器官功能衰竭和不利的结果。它的发展通常由病毒感染引发，例如甲型流感病毒，但尚不清楚是否也由严重急性呼吸系统综合症冠状病毒-2（SARS-CoV-2）引发。我们旨在调查 SARS-CoV-2 与 SCLS 之间的关联。

方法：我们介绍了一名 55 岁女性感染 SARS-CoV-2 后发展为 SCLS 的病例。此外，我们对文献进行了系统回顾，以确定与其他病例的任何共同特征并描述临床特征和结果。

结果：我们发现 2020 年 SARS-CoV-2 感染期间发生了另外三例 SCLS。将所有病例加在一起，平均年龄为 50 岁（范围 38-63），性别比为 1:1。呼吸系统表现是最常见的症状，所有患者都需要入住重症监护室。死亡率为50%。

结论：SARS-CoV-2 感染可能通过促炎细胞因子的过度产生或内皮细胞的直接病毒感染引发 SCLS 疾病。由于 SCLS 的预后可能较差，因此在每一个 SARS-CoV-2 感染患者中，都表现出低血容量性休克、血液浓缩和低蛋白血症的提示性三联征，应考虑 SCLS 诊断并开始早期治疗。