Fabry disease patients have an increased risk of stroke in the COVID-19 ERA: A hypothesis

Abstract

Stroke is a severe and frequent complication of Fabry disease (FD), affecting both males and females.Cerebrovascular complications are the end result of multiple and complex pathophysiology mechanisms involving endothelial dysfunction and activation, development of chronic inflammatory cascades leading to aprothrombotic state in addition to cardioembolic stroke due to cardiomyopathy and arrhythmias. The recentcoronavirus disease 2019 outbreak share many overlapping deleterious pathogenic mechanisms with those of FDand therefore we analyze the available information regarding the pathophysiology mechanisms of both disordersand hypothesize that there is a markedly increased risk of ischemic and hemorrhagic cerebrovascular complications in Fabry patients suffering from concomitant SARS-CoV-2 infections.