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COVID-19 in Individuals with Severe Alpha 1-Antitrypsin Deficiency
Hanan Tanash1, Erona Tahiri Blakaj1, Eeva Piitulainen1
1Department of Medicine, Skåne University Hospital, Lund University, Lund, Sweden.
International Journal of Chronic Obstructive Pulmonary Disease
|December 16, 2024
Summary
Individuals with severe alpha-1-antitrypsin deficiency (AATD) generally experienced mild COVID-19. However, those with co-occurring COPD faced a significantly higher risk of severe coronavirus infection.
Area of Science:
- Pulmonology
- Infectious Diseases
- Genetics
Background:
- Chronic conditions influence COVID-19 severity.
- The impact of severe hereditary alpha-1-antitrypsin deficiency (AATD) on COVID-19 risk was previously unknown.
- The role of COPD in severe COVID-19 outcomes for AATD patients required investigation.
Purpose of the Study:
- To examine COVID-19 outcomes in individuals with severe AATD.
- To determine if COPD exacerbates severe COVID-19 risk in this population.
Main Methods:
- A cohort of 863 individuals with severe AATD (PiZZ phenotype) was studied between 2021-2023.
- COVID-19 outcomes were collected via interviews and registered in the Swedish National AATD Registry.
- Cox regression models analyzed the association between COPD and mild/severe COVID-19 outcomes.
Main Results:
- 231 out of 863 severe AATD patients reported COVID-19 (208 mild, 23 severe).
- Severe COVID-19 cases were linked to older age, lower FEV1, smoking history, and comorbidities.
- COPD presence correlated with a 5-fold increased risk of severe COVID-19 (HR 5.43), remaining significant after adjustments (HR 3.72).
Conclusions:
- Most severe AATD patients experience mild COVID-19, manageable outside hospitals.
- The presence of COPD significantly elevates the risk of severe COVID-19 in individuals with severe AATD.
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