People with hereditary angioedema (HAE) suffered stress-related sequelae during the COVID-19 pandemic, including enhanced disease morbidity and reduced quality of life, according to an article published in the journal Allergy and Asthma Proceedings.

The researchers recruited people with HAE, both due to C1-inhibitor deficiency and those with normal C1-inhibitor levels, as well as their household members as healthy controls. All participants were requested to complete online questionnaires evaluating the impact of the COVID-19 pandemic on attack frequency, observed effectiveness of HAE medications, stress, and perceived quality of life and/or well-being.

According to the results, patients with HAE experienced significantly higher disease morbidity and psychological stress during the COVID-19 pandemic than before the pandemic onset. They also reported an increase in the frequency of HAE attacks due to the COVID-19 infection.

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Moreover, the well-being and optimism of control participants were negatively affected by the pandemic. Adverse outcomes were related to an increase in comorbidities such as anxiety, depression, and posttraumatic stress disorder.

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Women appeared to be more negatively affected by the pandemic than men. They reported a higher decrease in overall well-being as well as higher levels of anxiety, depression, and PTSD, compared with male patients. Female participants were also more affected by the pandemic-related job loss than men.  

“The results implicated a deleterious impact of stress in the aftermath of COVID-19 awareness on HAE morbidity. The female subjects were universally more severely affected than the male subjects. Overall well-being and/or quality of life, and optimism for the future deteriorated after awareness of the COVID-19 pandemic for the subjects with HAE and non-HAE household controls,” Christiansen and colleagues concluded.

Regardless of the pandemic, HAE diagnosis is associated with poor quality of life as a result of the unpredictable swelling attacks and pain that occurs during abdominal episodes, as well as the risk of death from asphyxiation during laryngeal attacks.


Christiansen SC, Lopes Veronez C, Smith TD, Riedl MA, Zuraw BL. Hereditary angioedema: impact of COVID-19 pandemic stress upon disease related morbidity and well-beingAllergy Asthma Proc. Published online March 01, 2023.  doi:10.2500/aap.2023.44.220096