Introduction: Differential diagnosis between angiotensin converting enzyme inhibitors (ACEi) angioedema (AE) and idiopathic histaminergic AE (ihAE) is often challenging. Follow-up data may help discriminate these conditions but are scarcely reported. Our objective was to report on the follow-up of patients with suspected ACEi-AE and to describe the baseline characteristics of AE attacks in patients with a diagnosis confirmed by follow-up. Methods: Sixty-four patients with suspected ACEi-AE (i.e. with exposure to ACEi before first attack, no urticaria associated and normal C1-inhibitor levels) and at least one follow-up visit were included. Data were retrospectively collected at baseline and during follow-up. Results: After follow-up, the diagnosis of ACEi-AE was confirmed in only 30 patients. The remaining patients were reclassified as ihAE (21 patients) or undetermined-mechanism AE (13 patients). In ACEi-AE patients, attacks occurred mostly in men (61%) with a median age of 64 (interquartile range 17) years old, with a highly variable delay from ACEi introduction (23103 months), and preferential involvement of lips (50%), tongue (47%) and throat (30%). Patients with confirmed ACEi-AE frequently reported classical histaminergic features, such as history of allergy and atopic conditions (20%), attacks with preferential evening onset (25%) and spontaneous resolution <24h (26%). ACEi-AE attacks responded to icatibant (79%). Conclusion: A final diagnosis of ihAE is frequent in patients with an initial suspicion of ACEi-AE; and follow-up should be systematically performed to ascertain the diagnosis in this population. Baseline clinical features seem insufficient to accurately discriminate between ACEi-AE and histaminergic AE, highlighting an unmet need for diagnostic biomarkers.

Objective - Determine what is the best initial clinical score to evaluate and propose adequate management to pregnant women with suspicion of COVID-19 infection. Design – setting – population: Retrospective study in one center (Lille, France) from 15 March 2020 to 15 April 2020. Were included all pregnant consulting in our emergency center for a suspicion of COVID-19 infection. Methods – main outcome measures: Women had a clinical, radiologic and biologic first evaluation to adapt management at home or in hospitalization. The National Early Warning Score (NEWS) and the NEWS-PREG, which is an adaptation including trimester of pregnancy, were calculated in posteriori for each patient. Sensitivity, specificity, predictive positive and negative value of these scores to propose adequate management were calculated. Results: 63 women were included. Seventeen were hospitalized (27%) among 4 in intensive care (6,5%). Sensitivity, specificity, predictive positive value and predictive negative value to predict hospitalization of the NEWS were respectively 52.9%, 100%, 100% and 85.2%. There were respectively 82.4%, 93.5%, 82.4% and 93.4% for the NEWS-PREG. Areas under the curve to predict hospitalization of the two scores were 0.77 for the NEWS and 0.88 for the NEWS-PREG. No woman was readmitted or had to be transferred from conventionel hospitalization to intensive care within 48 hours of her initial assessment and orientation. Conclusion: The NEWS-PREG is an interesting initial clinical score which can be used in case of suspicion of COVID-19 infection to propose adequate management. It will be interesting to evaluate in a prospective study.