Deaths from Angioedema-Anaphylaxis and Covid-19

Angioedema is non-dependent, non-pitting edema at a variety of sites. Its forms can be divided into histamine-mediated and bradykinin-mediated types. Histamine-mediated forms can present similarly to anaphylaxis with urticaria and itching, while bradykinin-mediated angioedema is slower in onset, presents with greater facial oropharyngeal involvement, and has a higher risk of progression. Bradykinin-mediated angioedema is of particular importance as it will not respond to the usual medications used in histamine-mediated anaphylaxis (steroids, antihistamines, epinephrine, etc). In this report, we present two cases of angioedema-induced death with coexisting COVID-19 infections in two male decedents. The associated gross autopsy, histology, and laboratory values will be discussed in detail. This article will highlight the importance of early detection and adequate treatment for the type of angioedema being evaluated as well as a discussion regarding the relationship between COVID-19 and angioedema.