Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients
David Nygren,1 Ulrica Mölstad,2 Hans Thulesius,2– 4 Magnus Hillman,5,6 Lars Mikael Broman,7,8 Hanan Tanash,9,10 Mona Landin-Olsson,5,6 Magnus Rasmussen,1 Maria Thunander2,6,11 1Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; 2Department of Research and...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-06-01
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| Series: | International Journal of General Medicine |
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| Online Access: | https://www.dovepress.com/low-prevalence-of-mild-alpha-1-antitrypsin-deficiency-in-hospitalized--peer-reviewed-fulltext-article-IJGM |
| _version_ | 1818549396283850752 |
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| author | Nygren D Mölstad U Thulesius H Hillman M Broman LM Tanash H Landin-Olsson M Rasmussen M Thunander M |
| author_facet | Nygren D Mölstad U Thulesius H Hillman M Broman LM Tanash H Landin-Olsson M Rasmussen M Thunander M |
| author_sort | Nygren D |
| collection | DOAJ |
| description | David Nygren,1 Ulrica Mölstad,2 Hans Thulesius,2– 4 Magnus Hillman,5,6 Lars Mikael Broman,7,8 Hanan Tanash,9,10 Mona Landin-Olsson,5,6 Magnus Rasmussen,1 Maria Thunander2,6,11 1Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; 2Department of Research and Development, Health Care Region Kronoberg, Växjö, Sweden; 3Department of Medicine and Optometry, Linnaeus University, Växjö, Sweden; 4Department of Clinical Sciences, Family Medicine, Lund University, Malmö, Sweden; 5Diabetes Research Laboratory, Biomedical Center, Lund University, Lund, Sweden; 6Department of Clinical Sciences, Endocrinology and Diabetes, Lund University, Lund, Sweden; 7ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; 8Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; 9Department of Clinical Sciences, Respiratory Medicine, Lund University, Malmö, Sweden; 10Department of Respiratory Medicine, Skåne University Hospital, Malmö, Sweden; 11Department of Internal Medicine, Endocrinology, Växjö Central Hospital, Växjö, SwedenCorrespondence: David Nygren, Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden, Tel +4646171192, Fax +4646176002, Email david.nygren@med.lu.seIntroduction: 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.Keywords: alpha-1-antitrypsin, alpha-1-antitrypsin deficiency, COVID-19, SARS-CoV-2, PI-typing, SERPINA1 |
| first_indexed | 2024-12-12T08:32:48Z |
| format | Article |
| id | doaj.art-fd0a56bd59854680a5ced2ec0d6d9985 |
| institution | Directory Open Access Journal |
| issn | 1178-7074 |
| language | English |
| last_indexed | 2024-12-12T08:32:48Z |
| publishDate | 2022-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of General Medicine |
| spelling | doaj.art-fd0a56bd59854680a5ced2ec0d6d99852022-12-22T00:31:03ZengDove Medical PressInternational Journal of General Medicine1178-70742022-06-01Volume 155843584876211Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-PatientsNygren DMölstad UThulesius HHillman MBroman LMTanash HLandin-Olsson MRasmussen MThunander MDavid Nygren,1 Ulrica Mölstad,2 Hans Thulesius,2– 4 Magnus Hillman,5,6 Lars Mikael Broman,7,8 Hanan Tanash,9,10 Mona Landin-Olsson,5,6 Magnus Rasmussen,1 Maria Thunander2,6,11 1Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden; 2Department of Research and Development, Health Care Region Kronoberg, Växjö, Sweden; 3Department of Medicine and Optometry, Linnaeus University, Växjö, Sweden; 4Department of Clinical Sciences, Family Medicine, Lund University, Malmö, Sweden; 5Diabetes Research Laboratory, Biomedical Center, Lund University, Lund, Sweden; 6Department of Clinical Sciences, Endocrinology and Diabetes, Lund University, Lund, Sweden; 7ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; 8Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; 9Department of Clinical Sciences, Respiratory Medicine, Lund University, Malmö, Sweden; 10Department of Respiratory Medicine, Skåne University Hospital, Malmö, Sweden; 11Department of Internal Medicine, Endocrinology, Växjö Central Hospital, Växjö, SwedenCorrespondence: David Nygren, Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden, Tel +4646171192, Fax +4646176002, Email david.nygren@med.lu.seIntroduction: 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.Keywords: alpha-1-antitrypsin, alpha-1-antitrypsin deficiency, COVID-19, SARS-CoV-2, PI-typing, SERPINA1https://www.dovepress.com/low-prevalence-of-mild-alpha-1-antitrypsin-deficiency-in-hospitalized--peer-reviewed-fulltext-article-IJGMalpha-1-antitrypsinalpha-1-antitrypsin deficiencycovid-19sars-cov-2pi-typingserpina1 |
| spellingShingle | Nygren D Mölstad U Thulesius H Hillman M Broman LM Tanash H Landin-Olsson M Rasmussen M Thunander M Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients International Journal of General Medicine alpha-1-antitrypsin alpha-1-antitrypsin deficiency covid-19 sars-cov-2 pi-typing serpina1 |
| title | Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients |
| title_full | Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients |
| title_fullStr | Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients |
| title_full_unstemmed | Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients |
| title_short | Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients |
| title_sort | low prevalence of mild alpha 1 antitrypsin deficiency in hospitalized covid 19 patients |
| topic | alpha-1-antitrypsin alpha-1-antitrypsin deficiency covid-19 sars-cov-2 pi-typing serpina1 |
| url | https://www.dovepress.com/low-prevalence-of-mild-alpha-1-antitrypsin-deficiency-in-hospitalized--peer-reviewed-fulltext-article-IJGM |
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