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Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients

Nygren, David LU orcid ; Mölstad, Ulrica ; Thulesius, Hans LU ; Hillman, Magnus LU ; Broman, Lars Mikael ; Tanash, Hanan LU ; Landin-Olsson, Mona LU ; Rasmussen, Magnus LU and Thunander, Maria LU (2022) In International Journal of General Medicine 15. p.5843-5848
Abstract

Introduction: Alpha-1-antitrypsin (AAT) has been shown to inhibit SARS-CoV-2 cell entry and suggested as a therapeutic agent for COVID-19. Furthermore, epidemiological association of high prevalence of Alpha-1-antitrypsin deficiency (AATD) and regional severity of COVID-19-impact has been hypothesized. In our study setting, the estimated prevalence rates of mild (PI*MZ, PI*SS or PI*MS) and moderate-to-severe AATD (PI*ZZ or PI*SZ) are high, 9% and 0.2%, respectively. Our primary aim was to examine the prevalence rate of AATD among hospitalized COVID-19-patients. Methods: In this prospective observational study, enrollment occurred from December 2020 to January 2021 in two COVID-19-units at Skåne University Hospital, Lund, Sweden. Case... (More)

Introduction: Alpha-1-antitrypsin (AAT) has been shown to inhibit SARS-CoV-2 cell entry and suggested as a therapeutic agent for COVID-19. Furthermore, epidemiological association of high prevalence of Alpha-1-antitrypsin deficiency (AATD) and regional severity of COVID-19-impact has been hypothesized. In our study setting, the estimated prevalence rates of mild (PI*MZ, PI*SS or PI*MS) and moderate-to-severe AATD (PI*ZZ or PI*SZ) are high, 9% and 0.2%, respectively. Our primary aim was to examine the prevalence rate of AATD among hospitalized COVID-19-patients. Methods: In this prospective observational study, enrollment occurred from December 2020 to January 2021 in two COVID-19-units at Skåne University Hospital, Lund, Sweden. Case definition was a patient hospitalized due to COVID-19. Patients were screened for AATD with PI-typing and if results were inconclusive, PCR for the S-and Z-genes were performed. Patients were categorized as severe or moderate COVID-19 and 30-day-mortality data were collected. The primary outcome was prevalence rate of AATD. The secondary outcome investigated association between presence of mild AATD and severe COVID-19. Results: We enrolled 61 patients with COVID-19. Two patients out of 61 (3%) had mild AATD (PI*MZ) and none had moderate-to-severe AATD. 30/61 (49%) had severe COVID-19. Both patients with mild AATD developed severe COVID-19. Yet, presence of AATD was not significantly associated with severe COVID-19 (p=0.24). Conclusion: Mild AATD (PI*MS or PI*MZ) was rare in a small cohort of hospitalized patients with COVID-19 in a study setting with a high background prevalence of AATD.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
alpha-1-antitrypsin, alpha-1-antitrypsin deficiency, COVID-19, PI-typing, SARS-CoV-2, SERPINA1
in
International Journal of General Medicine
volume
15
pages
6 pages
publisher
Dove Medical Press Ltd.
external identifiers
  • scopus:85133541489
  • pmid:35789772
ISSN
1178-7074
DOI
10.2147/IJGM.S370434
language
English
LU publication?
yes
id
af240ca6-6560-4c94-b595-6ced047c9e0d
date added to LUP
2022-09-27 11:24:22
date last changed
2024-06-13 19:37:13
@article{af240ca6-6560-4c94-b595-6ced047c9e0d,
  abstract     = {{<p>Introduction: Alpha-1-antitrypsin (AAT) has been shown to inhibit SARS-CoV-2 cell entry and suggested as a therapeutic agent for COVID-19. Furthermore, epidemiological association of high prevalence of Alpha-1-antitrypsin deficiency (AATD) and regional severity of COVID-19-impact has been hypothesized. In our study setting, the estimated prevalence rates of mild (PI*MZ, PI*SS or PI*MS) and moderate-to-severe AATD (PI*ZZ or PI*SZ) are high, 9% and 0.2%, respectively. Our primary aim was to examine the prevalence rate of AATD among hospitalized COVID-19-patients. Methods: In this prospective observational study, enrollment occurred from December 2020 to January 2021 in two COVID-19-units at Skåne University Hospital, Lund, Sweden. Case definition was a patient hospitalized due to COVID-19. Patients were screened for AATD with PI-typing and if results were inconclusive, PCR for the S-and Z-genes were performed. Patients were categorized as severe or moderate COVID-19 and 30-day-mortality data were collected. The primary outcome was prevalence rate of AATD. The secondary outcome investigated association between presence of mild AATD and severe COVID-19. Results: We enrolled 61 patients with COVID-19. Two patients out of 61 (3%) had mild AATD (PI*MZ) and none had moderate-to-severe AATD. 30/61 (49%) had severe COVID-19. Both patients with mild AATD developed severe COVID-19. Yet, presence of AATD was not significantly associated with severe COVID-19 (p=0.24). Conclusion: Mild AATD (PI*MS or PI*MZ) was rare in a small cohort of hospitalized patients with COVID-19 in a study setting with a high background prevalence of AATD.</p>}},
  author       = {{Nygren, David and Mölstad, Ulrica and Thulesius, Hans and Hillman, Magnus and Broman, Lars Mikael and Tanash, Hanan and Landin-Olsson, Mona and Rasmussen, Magnus and Thunander, Maria}},
  issn         = {{1178-7074}},
  keywords     = {{alpha-1-antitrypsin; alpha-1-antitrypsin deficiency; COVID-19; PI-typing; SARS-CoV-2; SERPINA1}},
  language     = {{eng}},
  pages        = {{5843--5848}},
  publisher    = {{Dove Medical Press Ltd.}},
  series       = {{International Journal of General Medicine}},
  title        = {{Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients}},
  url          = {{http://dx.doi.org/10.2147/IJGM.S370434}},
  doi          = {{10.2147/IJGM.S370434}},
  volume       = {{15}},
  year         = {{2022}},
}