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Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors

Urticarial eruptions and angioedema are the most common cutaneous reactions in patients undergoing mRNA COVID-19 vaccinations. The vasoactive peptide bradykinin has long been known to be involved in angioedema and recently also in urticaria. Bradykinin is mainly catabolized by angiotensin-converting...

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Autores principales: Cugno, Massimo, Consonni, Dario, Lombardi, Andrea, Bono, Patrizia, Oggioni, Massimo, Uceda Renteria, Sara, Pesatori, Angela Cecilia, Castaldi, Silvana, Riboldi, Luciano, Bordini, Lorenzo, Nava, Carlo Domenico, Ceriotti, Ferruccio, Torri, Adriana, Tafuri, Francesco, Ghigliazza, Gabriele, Peyvandi, Flora, Bandera, Alessandra, Gori, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473401/
https://www.ncbi.nlm.nih.gov/pubmed/34579248
http://dx.doi.org/10.3390/vaccines9091011
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author Cugno, Massimo
Consonni, Dario
Lombardi, Andrea
Bono, Patrizia
Oggioni, Massimo
Uceda Renteria, Sara
Pesatori, Angela Cecilia
Castaldi, Silvana
Riboldi, Luciano
Bordini, Lorenzo
Nava, Carlo Domenico
Ceriotti, Ferruccio
Torri, Adriana
Tafuri, Francesco
Ghigliazza, Gabriele
Peyvandi, Flora
Bandera, Alessandra
Gori, Andrea
author_facet Cugno, Massimo
Consonni, Dario
Lombardi, Andrea
Bono, Patrizia
Oggioni, Massimo
Uceda Renteria, Sara
Pesatori, Angela Cecilia
Castaldi, Silvana
Riboldi, Luciano
Bordini, Lorenzo
Nava, Carlo Domenico
Ceriotti, Ferruccio
Torri, Adriana
Tafuri, Francesco
Ghigliazza, Gabriele
Peyvandi, Flora
Bandera, Alessandra
Gori, Andrea
author_sort Cugno, Massimo
collection PubMed
description Urticarial eruptions and angioedema are the most common cutaneous reactions in patients undergoing mRNA COVID-19 vaccinations. The vasoactive peptide bradykinin has long been known to be involved in angioedema and recently also in urticaria. Bradykinin is mainly catabolized by angiotensin-converting enzyme (ACE), which is inhibited by ACE inhibitors, a commonly employed class of antihypertensive drugs. We evaluated the risk of developing urticaria/angioedema after inoculation with the BNT162b2 mRNA COVID-19 vaccine in a population of 3586 health care workers. The influences of ACE inhibitors and selected potential confounding variables (sex, age, previous SARS-CoV-2 infection, and allergy history) were evaluated by fitting univariate and multivariable Poisson regression models. The overall cumulative incidence of urticaria/angioedema was 1.8% (65 out of 3586; 95% CI: 1.4–2.3%). Symptoms were mild, and no subject consulted a physician. Subjects taking ACE inhibitors had an adjusted three-fold increased risk of urticaria/angioedema (RR 2.98, 95% CI: 1.12–7.96). When we restricted the analysis to those aged 50 years or more, the adjusted RR was 3.98 (95% CI: 1.44–11.0). In conclusion, our data indicate that subjects taking ACE inhibitors have an increased risk of urticaria/angioedema after vaccination with the BNT162b2 mRNA COVID-19 vaccine. Symptoms are mild and self-limited; however, they should be considered to adequately advise subjects undergoing vaccination.
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spelling pubmed-84734012021-09-28 Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors Cugno, Massimo Consonni, Dario Lombardi, Andrea Bono, Patrizia Oggioni, Massimo Uceda Renteria, Sara Pesatori, Angela Cecilia Castaldi, Silvana Riboldi, Luciano Bordini, Lorenzo Nava, Carlo Domenico Ceriotti, Ferruccio Torri, Adriana Tafuri, Francesco Ghigliazza, Gabriele Peyvandi, Flora Bandera, Alessandra Gori, Andrea Vaccines (Basel) Brief Report Urticarial eruptions and angioedema are the most common cutaneous reactions in patients undergoing mRNA COVID-19 vaccinations. The vasoactive peptide bradykinin has long been known to be involved in angioedema and recently also in urticaria. Bradykinin is mainly catabolized by angiotensin-converting enzyme (ACE), which is inhibited by ACE inhibitors, a commonly employed class of antihypertensive drugs. We evaluated the risk of developing urticaria/angioedema after inoculation with the BNT162b2 mRNA COVID-19 vaccine in a population of 3586 health care workers. The influences of ACE inhibitors and selected potential confounding variables (sex, age, previous SARS-CoV-2 infection, and allergy history) were evaluated by fitting univariate and multivariable Poisson regression models. The overall cumulative incidence of urticaria/angioedema was 1.8% (65 out of 3586; 95% CI: 1.4–2.3%). Symptoms were mild, and no subject consulted a physician. Subjects taking ACE inhibitors had an adjusted three-fold increased risk of urticaria/angioedema (RR 2.98, 95% CI: 1.12–7.96). When we restricted the analysis to those aged 50 years or more, the adjusted RR was 3.98 (95% CI: 1.44–11.0). In conclusion, our data indicate that subjects taking ACE inhibitors have an increased risk of urticaria/angioedema after vaccination with the BNT162b2 mRNA COVID-19 vaccine. Symptoms are mild and self-limited; however, they should be considered to adequately advise subjects undergoing vaccination. MDPI 2021-09-11 /pmc/articles/PMC8473401/ /pubmed/34579248 http://dx.doi.org/10.3390/vaccines9091011 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Cugno, Massimo
Consonni, Dario
Lombardi, Andrea
Bono, Patrizia
Oggioni, Massimo
Uceda Renteria, Sara
Pesatori, Angela Cecilia
Castaldi, Silvana
Riboldi, Luciano
Bordini, Lorenzo
Nava, Carlo Domenico
Ceriotti, Ferruccio
Torri, Adriana
Tafuri, Francesco
Ghigliazza, Gabriele
Peyvandi, Flora
Bandera, Alessandra
Gori, Andrea
Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors
title Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors
title_full Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors
title_fullStr Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors
title_full_unstemmed Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors
title_short Increased Risk of Urticaria/Angioedema after BNT162b2 mRNA COVID-19 Vaccine in Health Care Workers Taking ACE Inhibitors
title_sort increased risk of urticaria/angioedema after bnt162b2 mrna covid-19 vaccine in health care workers taking ace inhibitors
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473401/
https://www.ncbi.nlm.nih.gov/pubmed/34579248
http://dx.doi.org/10.3390/vaccines9091011
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