Angiogenesis, hereditary hemorrhagic telangiectasia and COVID-19
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LETTER
Angiogenesis, hereditary hemorrhagic telangiectasia and COVID‑19 Antoni Riera‑Mestre1,2,3 · Adriana Iriarte1,3 · Manuela Moreno3,4 · Raul del Castillo3,5 · Daniel López‑Wolf3,6 Received: 28 September 2020 / Accepted: 5 October 2020 © The Author(s) 2020
Abstract Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal-dominant disease characterized by pathologic angiogenesis that provokes vascular overgrowth. The evidence about the influence of Acute Respiratory Syndrome Coronavirus-2 (SARSCoV-2) in patients with rare diseases is scarce. We aimed to know the prevalence of coronavirus disease 2019 (COVID-19) in HHT patients. The HHT pathogenic angiogenesis and endothelial injury in COVID-19 are discussed using data from RiHHTa (Computerized Registry of Hereditary Hemorrhagic Telangiectasia) registry. RiHHTa is an open, multicenter, prospective, observational registry including adult patients with HHT. A 27-item survey that captured clinical data of admitted HHT patients for COVID-19 was distributed to all RiHHTa investigators from June 8th to June 24th 2020. Only one out of 1177 HHT patients was admitted for COVID-19 pneumonia. She is a 74 years-old woman with a pathogenic variant in ACVRL1 gene. Her clinical course did not involve mechanical ventilation or worsening epistaxis, and she was successfully discharged after two weeks. The endothelial damage and the consequent angiogenic process in COVID-19 patients deserve further investigation. Keywords Hereditary hemorrhagic telangiectasia · Rare diseases · Angiogenesis · Coronavirus disease 2019 (COVID-19) · Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Abbreviations HHT Hereditary hemorrhagic telangiectasia ENG Endoglin ACVRL1 Activin A receptor type II-like 1 SARS-CoV-2 Severe Acute Respiratory Syndrome Coronavirus-2 COVID-19 Coronavirus disease 2019 * Antoni Riera‑Mestre [email protected] 1
Hereditary Hemorrhagic Telangiectasia Unit, Internal Medicine Department, Hospital Universitari de Bellvitge – IDIBELL, Feixa Llarga S/N, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
2
Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
3
RiHHTa (Computerized Registry of Hereditary Hemorrhagic Telangiectasia) Investigators. Rare Diseases Working Group of the Spanish Society of Internal Medicine, Madrid, Spain
4
Internal Medicine Department, Hospital Clínico Universitario San Cecilio, Granada, Spain
5
Otorhinolaryngology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
6
Internal Medicine Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
RiHHTa Computerized Registry of Hereditary Hemorrhagic Telangiectasia VEGF Vascular endothelial growth factor ICU Intensive care unit Dear Editor: Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal-dominant disease characterized by vascular malformations. Disease-causing variants are mostly detected in endoglin (ENG; encoding endoglin) and activin A receptor type II-like 1 (ACVRL1; encodin
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