Introduction Overall, patients with Sars-cov-2 disease treated with mechanical ventilation, which is not the case in our study. This report presents our first successful experience of awake ECMO application in a critical patient with hypoxemic Respiratory Failure related to COVID-19 infection in Morocco. Case management We have reported a 52-year-old female patient who was diagnosed with COVID-19 infection and progressed to critical cases. She was a candidate for applying awake extracorporeal membrane oxygenation (ECMO) in the absence of invasive mechanical ventilation, under local anesthesia alone with good progress and ventilatory weaning. Conclusion This therapeutic attitude can be beneficial for certain critical and severe cases due to COVID-19 infection. Each ECMO program should develop goals, methods, protocols, and best practices while adapting appropriately to the personnel and equipment available.

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Introduction SARS-CoV-2 viral infection can manifested by respiratory symptoms, or other symptoms, such as the cardiovascular manifestations including acute coronary syndrome, pericardial effusion, and heart failure. Clinical case A 51-year-old patient admitted to the emergency room for epigastric pain with no respiratory signs and with an ST-segment elevation inelectrocardiogram that ultimately revealed myocarditis and SARS CoV-2 2 infection. Conclusion The clinical manifestations of SARS CoV-2 might be atypical, and the diagnosis might be considered in this pandemic area

It has been observed that mental disorder is associated with an aggravation of COVID 19 disease. A 44-year-old male patient, with no medical history, admitted to the emergency room for dyspnea, the exploration revealed SARS-COV-2 pneumonia. The patient was stable until he was aware of the death of his sister by COVID 19, he was admitted into the intensive care unit 24hours later in a serious condition after worsening of the inflammatory balance and pulmonary lesions. COVID 19 requires appropriate mental health management to help improve the prognosis of this disease.

Introduction COVID19 infection is most often reveled by pulmonary symptoms, however cardiovascular manifestations has been observed revealing this infection with absence of respiratory symptoms. Clinical case A 62 year old female patient, with no medical history, admitted to the emergency room for epigastric pain, with no respiratory signs, the exploration revealed myocardial infarction with COVID 19 infection. Conclusion COVID19 infection manifest mainly with respiratory symptoms but it can also be revealed by cardiac manifestations with absence of respiratory symptoms. Physicians must be aware of these atypical manifestations and act accordingly to isolate patients to limit the spread of this disease.

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