COVID-19 affecting hereditary angioedema patients with and without C1 inhibitor deficiency

Grumach, Anete Sevciovic; Goudouris, Ekaterini; Dortas, Sérgio Duarte; Marcelino, Fernanda Casares; Alonso, Maria Luiza Oliva; Martins, Raquel de Oliveira; Arpon, Maria Angelica; Valle, Solange Oliveira Rodrigues

doi:10.1016/j.jaip.2020.11.042

Cited by 32 publications

(43 citation statements)

References 9 publications

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“…These results are in line with those of Grumach et al10 Indeed, in their cohort of 13 patients, 5 (38%) experienced attacks days after SARS-CoV-2 infection, mostly affected extremities and face. Acute attacks could occur during the convalescent phase of COVID-19 illness, more commonly in patients with a history of frequent attacks.…”

supporting

confidence: 92%

COVID‐19 as a trigger of acute attacks in people with hereditary angioedema

Belbézier

Arnaud

Boccon‐Gibod

et al. 2021

Clin Experimental Allergy

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supporting

confidence: 92%

COVID‐19 as a trigger of acute attacks in people with hereditary angioedema

Belbézier

Arnaud

Boccon‐Gibod

et al. 2021

Clin Experimental Allergy

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“…23 A previously reported series of 11 young women and 2 young men taking oxandrolone or tranexamic acid for hereditary angioedema-reported COVID-19 symptom frequency of anosmia/dysgeusia of 77% and dyspnoea of 31%. 24 In a communication with the authors, at their hereditary angioedema clinic, oxandrolone is prescribed at lower dosages (4-5 mg/day) for angioedema prophylaxis, and the only woman who required hospitalisation was not using oxandrolone. We raise the possibility that DHT-derived AAS may lead to increased disease severity in a dose-dependent manner.…”

Section: Discussionmentioning

confidence: 99%

Expression of concern: potential risk for developing severe COVID-19 disease among anabolic steroid users

Cadegiani

Lin

Goren³

et al. 2021

BMJ Case Rep

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A severe case of COVID-19 was observed in an otherwise healthy 28-year-old man who had taken oxandrolone 40 mg/day as an anabolic steroid. The patient had been taking oxandrolone for enhanced bodybuilding 30 days prior to presenting to an outpatient clinic with COVID-19 symptoms. The patient reported that his symptoms have rapidly worsened over the course of 4 days prior to presenting at the clinic. As part of an experimental antiandrogen treatment for hyperandrogenic men suffering from COVID-19, he was administered a single 600 mg dose of the novel antiandrogen proxalutamide. Twenty-four hours after administration of this dose, marked improvement of symptoms and markers of disease severity were observed. To our knowledge, this is the first case that potentially links anabolic steroid use to COVID-19 disease severity.

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“…We collected data from 121 patients diagnosed with IEI and infected by SARS-CoV-2 between March and December 2020. The diagnosis of SARS-CoV-2 infection was con rmed by RT-PCR from nasopharyngeal or nasal swab in 82 patients (67.8%); by RT-PCR and serology, in three patients ( [26] and one common variable immunode ciency (CVID) patient was previously reported [20].…”

Section: Resultsmentioning

confidence: 99%

“…Sixty-seven patients were female (55.4%). Four out of 121 patients were previously included in Meyts et al [14], 13 patients with hereditary angioedema were included in Grumach et al [26] and one common variable immunode ciency (CVID) patient was previously reported [20].…”

Section: Resultsmentioning

confidence: 99%

“…It is essential to report that only one of our patients (CVID, previously published) received convalescent plasma (not widely available in Brazil), described as effective in some patients with antibody de ciencies [13,20,47]. We rati ed ndings from previous publications [26,48] on the prevalence of mild conditions among patients with complement de ciencies, and more than one third presented edema attacks.…”

Section: Discussionmentioning

confidence: 96%

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Outcome of SARS-CoV-2 Infection in 121 Patients With Inborn Errors of Immunity: A Cross-sectional Study

Goudouris

Pinto‐Mariz

Mendonça

et al. 2021

Preprint

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Purpose: There is still scarce data on SARS-CoV-2 infection in patients with Inborn Errors of Immunity (IEI) and many questions. We aimed to describe the clinical outcome of SARS-CoV-2 infection in Brazilian IEI patients and to identify factors influencing the outcome of infection.Methods: We did a cross-sectional, multicenter study that included patients of any age affected by IEI and SARS-CoV-2 infection. The variables studied were sex, age, type of IEI, comorbidities (number and type), treatment in use for IEI, clinical manifestations and severity of SARS-CoV-2 infection. Results: 121 patients were included: 55.4% female, ages from six months to 74 yo (median age = 25.1 yo). Most patients had predominantly antibody deficiency (n=53). The infection presented mostly as asymptomatic (n=21) and mild (n=66), and one child had multisystem inflammatory syndrome (MIS-C). We could not observe sex related susceptibility and observed a weak correlation between age and severity of infection. The number of comorbidities was higher in severe cases, particularly bronchiectasis and cardiopathy. There were no severe cases in hereditary angioedema patients. Six patients aged 2 to 74 years died, three of them with antibody deficiency. Conclusion: The outcome was mild in most patients, but the Case Fatality Ratio was higher than in the general population. Patients with complement deficiencies had milder COVID-19. However, the type of IEI was not a determining factor for severity. The severity of SARS-CoV-2 infection seems to be more related to older age, higher number of comorbidities and type of comorbidities (bronchiectasis and cardiopathy).

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COVID-19 affecting hereditary angioedema patients with and without C1 inhibitor deficiency

Cited by 32 publications

References 9 publications

COVID‐19 as a trigger of acute attacks in people with hereditary angioedema

COVID‐19 as a trigger of acute attacks in people with hereditary angioedema

Expression of concern: potential risk for developing severe COVID-19 disease among anabolic steroid users

Outcome of SARS-CoV-2 Infection in 121 Patients With Inborn Errors of Immunity: A Cross-sectional Study

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