Management of Patients with Hereditary Angioedema During the COVID-19 Pandemic

IF 0.3 Q4 ALLERGY

Astim Allerji Immunoloji Pub Date : 2021-12-22 DOI:10.21911/aai.661

Eray Yıldız, Ş. Arslan, Fatih Çölkesen, F. Aykan, R. Evcen, Mehmet Kılınç

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Abstract

Objective: The aim of this study was to determine the clinical course and treatment outcomes of patients with hereditary angioedema (HAE) after infection with coronavirus disease 2019 (COVID-19). Materials and Methods: Thirty-nine patients with HAE were included in this study. These patients were regularly followed up over phone calls since the first COVID-19 case was seen in our country. Patients were asked to visit the hospital if there was a history of contact with a confirmed COVID-19 patient or if the patient developed clinical symptoms of COVID-19.Results: There were 21 (54%) patients with type I HAE, and 18 (46%) with type II HAE. All patients received treatment for angioedema attacks (C1-inhibitor [C1-INH], icatibant), and seven (20%) received long-term prophylaxis (danazol). Treatment for attacks was continued for all patients during the pandemic. Patients taking danazol were switched to long-term prophylaxis using the C1-INH concentrate. Eleven (28%) patients with HAE developed COVID-19 during this study. Only one patient had severe COVID-19. Six patients (54.5%) were diagnosed with type II HAE, and five (45.5%) were diagnosed with type I HAE. The most common COVID-19 symptoms were fever (7/11; 64%) and myalgia (6/11; 55%). Mild angioedema attacks were experienced by 36% (4/11) of the HAE patients diagnosed with COVID-19. Icatibant was used in all patients.Conclusion: Agents used for HAE block the kallikrein-kinin system and may be useful in the treatment of COVID-19. Considering their beneficial effects on COVID-19, it is recommended that HAE patients should continue the use of agents blocking the kallikrein-kinin system. Keywords: COVID-19, hereditary angioedema, kallikrein-kinin system, bradykinin, C1-INH

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COVID-19大流行期间遗传性血管性水肿患者的管理

目的：本研究旨在确定2019冠状病毒病（新冠肺炎）感染后遗传性血管性水肿（HAE）患者的临床病程和治疗结果。材料与方法：本研究纳入39例HAE患者。自我国出现第一例新冠肺炎病例以来，这些患者定期通过电话进行随访。如果患者有与确诊的新冠肺炎患者接触史或出现新冠肺炎临床症状，则要求患者去医院就诊。结果：21名（54%）患者患有I型HAE，18名（46%）患者患有II型HAE。所有患者均接受血管性水肿发作治疗（C1抑制剂[C1-INH]，艾替班），7名（20%）患者接受长期预防治疗（达那唑）。在新冠疫情期间，所有患者都继续接受治疗。服用达那唑的患者改用C1-INH浓缩液进行长期预防。本研究期间，11名（28%）HAE患者出现新冠肺炎。只有一名患者患有严重的新冠肺炎。6名患者（54.5%）被诊断为II型HAE，5名患者（45.5%）被确诊为I型HAE。最常见的新冠肺炎症状是发烧（7/11；64%）和肌痛（6/11；55%）。在诊断为新冠肺炎的HAE患者中，36%（4/11）的患者出现轻度血管性水肿发作。所有患者均使用伊西班特。结论：HAE药物阻断激肽释放肽-激肽系统，可用于治疗新冠肺炎。考虑到它们对新冠肺炎的有益作用，建议HAE患者继续使用阻断激肽释放肽-激肽系统的药物。关键词：新冠肺炎，遗传性血管性水肿，激肽释放肽-激肽系统，缓激肽，C1-INH

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来源期刊

Astim Allerji Immunoloji ALLERGY-

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： Asthma Allergy Immunology has been published three times a year in April, August and December as the official and periodical journal of the Turkish National Society of Allergy and Clinical Immunology since 2003. All articles published in the journal have been available online since 2003. A peer reviewed system is used in evaluation of the manuscripts submitted to Asthma Allergy Immunology. The official language of the journal is English. The aim of the journal is to present advances in the field of allergic diseases and clinical immunology to the readers. In accordance with this goal, manuscripts in the format of original research, review, case report, articles about clinical and practical applications and editorials, short report and letters to the editor about allergic diseases and clinical immunology are published in the journal. The target reader population of the Asthma Allergy Immunology includes specialists and residents of allergy and clinical immunology, pulmonology, internal medicine, pediatrics, dermatology and otolaryngology as well as physicians working in other fields of medicine interested in allergy and immunological diseases.