Assessing the Impact of COVID-19 in Severe Alpha-1 Antitrypsin Deficiency (AATD)

Title: Assessing the Impact of COVID-19 in Severe Alpha-1 Antitrypsin Deficiency (AATD)
Author(s): KMcGoldrick, D Fraughen, T Carroll, G Kelly, C Gunaratnam, G McElvaney.
Institution: Irish Centre for Genetic Lung Disease, RCSI Education and Research Centre, Beaumont Hospital.
Poster: Click to view poster
Category: COPD/Asthma
Abstract: Alpha-1 antitrypsin deficiency (AATD) is a genetic disorder arising from mutation of the SERPINA1 gene. The ZZ genotype of AATD results in severe deficiency of this key antiprotease and can lead to chronic obstructive pulmonary disease (COPD), even in never-smokers. As a respiratory pathogen, SARS-CoV-2 is presumed to pose a heightened risk to those with severe AATD and, as such, they were advised to cocoon. This study aimed to contextualize the impact of COVID-19 in this cohort.

Through the National AATD Registry, 184 eligible ZZ individuals were invited to participate via phone. Data on exacerbation frequency, COVID infection status and cocooning history were collected via a survey. The overall response rate was 63.5% (N=117).

The prevalence of COVID-19 infection in our cohort was 12.3% (N=12/117) with 4.2% of cases requiring hospital admission (N=5) and no fatalities. Men who cocooned were the only group shown to have fewer exacerbations during the pandemic.

Limitations of our study include the lack of COVID-19 diagnosis dates and the fact outcomes are patient reported. Nevertheless, our data show that men with severe AATD had fewer exacerbations in the COVID-19 era.