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In this case series, the authors highlight 4 cases of angioedema in African American patients with COVID-19 to understand the association between the two conditions. To explain the possible mechanism, they discuss a “2-hit hypothesis” in which African Americans with a genetic polymorphism predisposing to angioedema experience secondary dysregulation of ACE2 from COVID-19 infection, resulting in the “second hit” of angioedema. A similar phenomenon has been seen in patients on ACE inhibitors who then get infected with COVID-19.
Although no causal relationship can be derived from this small case series, the authors bring awareness to this unique entity, providing a basis for further investigation.
– Morgan Soffler, MD
This abstract is available on the publisher's site.
We report four angioedema cases in patients admitted to the intensive care unit (ICU) at Buffalo General Medical Center. Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection was diagnosed in all patients by real-time reverse-transcriptase-polymerase chain reaction (qRT-PCR). Diagnosis of angioedema was based on clinical presentation, including classical features of acute onset of subcutaneous and submucosal swelling affecting the face, lips, mouth, and tongue without urticaria (1).