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COVID-19 outcomes in individuals with severe alpha-1 antitrypsin deficiency in Sweden

Zaigham, Suneela LU ; Piitulainen, Eeva LU and Tanash, Hanan LU (2026) In Scientific Reports 16(1).
Abstract

We have previously found using questionnaire/interview data on COVID-19 outcomes, that most subjects with severe alpha-1-antitrypsin deficiency (AATD) exhibit mild COVID-19 infection and those who additionally have COPD are at increased risk of severe COVID-19. We used objective information on COVID-19 outcomes in severe AATD (PiZZ) from the Swedish population and compared the risk of severe COVID-19 in severe AATD to the risk of severe COVID-19 in the general population. We cross-linked the Swedish National AATD Registry with the Swedish National Patient Register to identify subjects with severe AATD that required COVID-19-related hospitalization between March 2020 until June 2023. Standardised incidence ratio (SIR) was calculated... (More)

We have previously found using questionnaire/interview data on COVID-19 outcomes, that most subjects with severe alpha-1-antitrypsin deficiency (AATD) exhibit mild COVID-19 infection and those who additionally have COPD are at increased risk of severe COVID-19. We used objective information on COVID-19 outcomes in severe AATD (PiZZ) from the Swedish population and compared the risk of severe COVID-19 in severe AATD to the risk of severe COVID-19 in the general population. We cross-linked the Swedish National AATD Registry with the Swedish National Patient Register to identify subjects with severe AATD that required COVID-19-related hospitalization between March 2020 until June 2023. Standardised incidence ratio (SIR) was calculated using observed COVID-19 hospitalisations in severe AATD and expected COVID-19 hospitalisations from the general population. Logistic regression was used to calculate odds of moderate or severe COVID-19 in severe AATD in relation to pre-existing comorbidities. In 1228 subjects with severe AATD, there were 61 cases of COVID-19-related hospitalisations (severe COVID-19) and 32 moderate COVID-19 during follow-up. The observed hospitalizations for COVID-19 in subjects with severe AATD exceeded that expected in the general population by over threefold (SIR = 3.4). Odds of COVID-19 was elevated in subjects with severe AATD with COPD or CVD (OR 2.70 (1.52–4.80) and 3.51 (2.04–6.06), respectively. The majority of subjects with severe AAT deficiency had mild COVID-19 during the pandemic. Of subjects that did have severe COVID-19, pre-existing co-morbidities were common, potentially explaining the higher rate of COVID-19 hospitalisations in severe AATD relative to the general population.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alpha-1 antitrypsin deficiency, COVID
in
Scientific Reports
volume
16
issue
1
article number
1616
publisher
Nature Publishing Group
external identifiers
  • scopus:105027347908
  • pmid:41526539
ISSN
2045-2322
DOI
10.1038/s41598-026-35016-4
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2026.
id
0c7687ff-bcf9-4fe8-85ce-01670edc4bb9
date added to LUP
2026-03-09 15:20:48
date last changed
2026-03-10 03:00:03
@article{0c7687ff-bcf9-4fe8-85ce-01670edc4bb9,
  abstract     = {{<p>We have previously found using questionnaire/interview data on COVID-19 outcomes, that most subjects with severe alpha-1-antitrypsin deficiency (AATD) exhibit mild COVID-19 infection and those who additionally have COPD are at increased risk of severe COVID-19. We used objective information on COVID-19 outcomes in severe AATD (PiZZ) from the Swedish population and compared the risk of severe COVID-19 in severe AATD to the risk of severe COVID-19 in the general population. We cross-linked the Swedish National AATD Registry with the Swedish National Patient Register to identify subjects with severe AATD that required COVID-19-related hospitalization between March 2020 until June 2023. Standardised incidence ratio (SIR) was calculated using observed COVID-19 hospitalisations in severe AATD and expected COVID-19 hospitalisations from the general population. Logistic regression was used to calculate odds of moderate or severe COVID-19 in severe AATD in relation to pre-existing comorbidities. In 1228 subjects with severe AATD, there were 61 cases of COVID-19-related hospitalisations (severe COVID-19) and 32 moderate COVID-19 during follow-up. The observed hospitalizations for COVID-19 in subjects with severe AATD exceeded that expected in the general population by over threefold (SIR = 3.4). Odds of COVID-19 was elevated in subjects with severe AATD with COPD or CVD (OR 2.70 (1.52–4.80) and 3.51 (2.04–6.06), respectively. The majority of subjects with severe AAT deficiency had mild COVID-19 during the pandemic. Of subjects that did have severe COVID-19, pre-existing co-morbidities were common, potentially explaining the higher rate of COVID-19 hospitalisations in severe AATD relative to the general population.</p>}},
  author       = {{Zaigham, Suneela and Piitulainen, Eeva and Tanash, Hanan}},
  issn         = {{2045-2322}},
  keywords     = {{Alpha-1 antitrypsin deficiency; COVID}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{COVID-19 outcomes in individuals with severe alpha-1 antitrypsin deficiency in Sweden}},
  url          = {{http://dx.doi.org/10.1038/s41598-026-35016-4}},
  doi          = {{10.1038/s41598-026-35016-4}},
  volume       = {{16}},
  year         = {{2026}},
}