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Abnormal Alpha-1 Antitrypsin Levels and Other Risk Factors Associated with Lung Function Impairment at 6 and 12

Beatriz María Jiménez-Rodríguez^1,2, Eva Maria Triviño-Ibáñez^3,4, José Gutiérrez-Fernández^2,3,5

¹Department of Pneumology, University Hospital Virgen de las Nieves, 18014 Granada, Spain.

Healthcare (Basel, Switzerland)

|December 23, 2022

Insights

Certain medical conditions significantly increase the risk of long-term lung function impairment after COVID-19. Alpha-1 antitrypsin deficiency (AATD) and specific clinical factors are key predictors of persistent respiratory issues post-SARS-CoV-2 infection.

Area of Science:

Pulmonology
Infectious Diseases
Genetics

Background:

COVID-19 frequently leads to lasting respiratory problems.
Identifying risk factors for prolonged lung impairment is crucial for patient management.

Purpose of the Study:

To determine factors influencing lung function 12 months post-COVID-19.
To investigate the role of alpha-1 antitrypsin deficiency (AATD) in long-term respiratory outcomes.

Main Methods:

A cohort study of hospitalized COVID-19 pneumonia patients.
Follow-up assessments included pulmonary function tests, AAT levels, and AATD genotyping at 6 and 12 months.
Multivariate analysis identified associated risk factors.

Main Results:

31.2% of patients had persistent lung function impairment at 12 months.
Factors associated with impairment included higher Charlson index, central/mixed pneumonia, anemia, ICU stay, corticosteroids, abnormal respiratory sounds, elevated lactate dehydrogenase, abnormal AAT, and MZ genotype.
AAT deficiency and specific clinical indicators were linked to poorer lung function outcomes.

Conclusions:

Several clinical and genetic factors predispose COVID-19 patients to long-term lung sequelae.
Early identification of patients with AATD and other risk factors may allow for targeted interventions to mitigate persistent respiratory deficits.

Read full analysis

Abstract:

Respiratory function deficits are common sequelae for COVID-19. In this study, we aimed to identify the medical conditions that may influence lung function impairment at 12 months after SARS-CoV2 infection and to analyze the role of alpha-1 antytripsin (AAT) deficiciency (AATD). A cohort study was conducted on hospitalized COVID-19 pneumonia patients in Granada (Spain) during the first infection wave who were referred to a post-COVID-19 hospital clinic. The patients were monitored with three follow-up visits from May 2020 to May 2021. Previous medical history, hospital admission data, baseline parameters and physical examination data were collected at the first visit. Pulmonary function tests were performed at 6 and 12 months together with the determination of AAT level and AATD genotype. After 12 months, 49 out of 157 patients (31.2%) continued to have lung function impairment. A multivariate analysis showed a statistically significant association of lung function impairment with: higher Charlson index; pneumonia with a central and/or mixed distribution; anemia on admission; time in intensive care; need for corticosteroid boluses; abnormal respiratory sounds at 6 months; elevated lactate dehydrogenase at 12 months; abnormal AAT; and MZ genotype. Our results suggest that these medical conditions predispose COVID-19 patients to develop long-term lung function sequelae.

Keywords:

COVID-19 alpha-1 antitrypsin long-term follow-up respiratory function tests

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