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

Belbézier, Aude; Arnaud, M; Boccon‐Gibod, Isabelle; Pelletier, F.; McAvoy, Chloé; Gobert, Delphine; Fain, Olivier; Du-Thanh, A.; Launay, David; Lupo, Julien; Bouillet, Laurence

doi:10.1111/cea.13870

Cited by 16 publications

(12 citation statements)

References 10 publications

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“…We ratified findings from previous publications [26,48] on the prevalence of mild conditions among patients with complement deficiencies, and more than a third presented edema attacks. Edema attacks in 31% of HAE patients during SARS-CoV-2 infections have also been described recently, but with two cases of severe infections [49].…”

Section: Discussionmentioning

confidence: 71%

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

Goudouris

Pinto‐Mariz

Mendonça³

et al. 2021

J Clin Immunol

154

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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 unresolved questions. We aimed to describe the clinical outcome of SARS-CoV-2 infection in Brazilian IEI patients and identify factors influencing the 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 was mostly asymptomatic (n = 21) and mild (n = 66), and one child had multisystem inflammatory syndrome (MIS-C). We could not observe sex-related susceptibility, and there was 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. However, the type of IEI was not a determining factor for severity, except for complement deficiencies linked to milder COVID-19. The severity of SARS-CoV-2 infection seems to be more related to older age, a higher number of comorbidities and type of comorbidities (bronchiectasis and cardiopathy).

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Section: Discussionmentioning

confidence: 71%

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

Goudouris

Pinto‐Mariz

Mendonça³

et al. 2021

J Clin Immunol

154

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“…Angioedema is characterized by swelling through dysregulation of histaminergic response or bradykinin, leading to an unchecked inflammatory cascade and vascular activation giving rise to vasodilation, increased permeability, and hypotension. SARS-Cov-2 (COVID-19) exhibits a similar mechanism by which desarginine (9)-bradykinin (DABK), an analog of bradykinin acting on the same receptors, is left unchecked by depleted angiotensin-converting enzyme 2 (ACE2) [1]. Coincident activation of inflammatory pathways in an individual with both hereditary angioedema (HAE) and COVID-19 infection is described in this case report.…”

Section: Introductionmentioning

confidence: 81%

The Interplay of COVID-19 and Hereditary Angioedema: Preventing an Acute Attack

Park¹,

Silvano²,

Gregory³

et al. 2022

Cureus

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Hereditary angioedema (HAE) is a rare inherited disease that is caused by the inactivation of the C1 esterase inhibitor. In this case report, we present a 51-year-old female previously diagnosed with HAE who tested positive for SARS-Cov-2 (COVID-19). The patient was treated symptomatically. Dexamethasone was used to treat COVID-19 pneumonia. Broad-spectrum antibiotics (vancomycin and meropenem) were utilized to prevent future infection. Although the patient did not experience an acute angioedema attack during her hospital stay, the patient expired due to the exacerbation of COVID-19 pneumonia.

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“…Initial data from Brazil, France, and Turkey showed no significant increase in HAE-1/2 activity during or after COVID-19, although some patients who were only using on-demand therapy did report increased HAE activity. 380 , 381 , 382 , 383 A manuscript, in press, using the database of the HAE-A demonstrated no evidence that HAE patients were at greater risk for infection or for serious infection, nor adverse effects to the vaccine. In a recent survey from the Netherlands, following 111 COVID-19 vaccine doses administered, 11 attacks were reported, 6 arose more than 48 h after vaccination.…”

Section: Patient Support Home Therapy and Self-administration And Oth...mentioning

confidence: 98%

The international WAO/EAACI guideline for the management of hereditary angioedema – The 2021 revision and update

Maurer

Magerl

Betschel

et al. 2022

World Allergy Organization Journal

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120

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

Abstract: Acute attacks could occur during the convalescent phase of COVID‐19 illness, more commonly in patients with a history of frequent attacks. However it is unclear whether the acute attacks during the convalescent phase are specifically triggered by COVID‐19 or not.

Cited by 16 publications

References 10 publications

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

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

The Interplay of COVID-19 and Hereditary Angioedema: Preventing an Acute Attack

The international WAO/EAACI guideline for the management of hereditary angioedema – The 2021 revision and update

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