COVID-19 infections and vaccination in patients with hereditary hemorrhagic telangiectasia – a cohort study

Abstract

Background: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant orphan disease, leading to malformations of blood vessels. Regarding the pandemic, both, the course of COVID-19 infection and the response to the vaccination and its pos- sible side effects, such as increased bleeding episodes, are still poorly investigated. Methodology: Retrospective single-center cohort study at the Department of Otolaryngology / Head & neck Surgery (University Hospital of Zurich, Switzerland) between February 14th and March 21th 2022. Among the 32 eligible adult patients with HHT, we collected patient- and disease-specific characteristics. The course of a COVID-19 infection including severity of the disease and symptoms were noted. We assessed changes in the Hereditary Hemorrhagic Telangiectasia Epistaxis Severity Score (HHT-ESS) before and after vaccination. Results: Out of the 32 patients, 5 patients suffered a COVID-19 infection, thereby mainly experiencing loss of taste and smell and cough. No significant change of the HHT-ESS before and after vaccination was observed. The median HHT-ESS before and after the vaccination was 4.06. Conclusions: There was no significant change in bleeding severity (HHT-ESS) before and after COVID-19 vaccination. Based on these findings, the vaccination for HHT patients does not seem to worsen the further course of the disease. The overall symptoms, risks and complications after Sars-CoV-2 vaccination and infection seem to be comparable to the general population.