COVID-19 does not seem to be associated with a poor outcome in patients with alpha-1 antitrypsin deficiency (AATD), according to a new study published in Archivos de Bronconeumología. Most patients survived the disease and recovered even if they had severe lung disease or were hospitalized.

“AATD patients remain concerned about contracting COVID-19 and continue to lead isolated lifestyles with consequences to health,” the researchers wrote. “Our data provides an estimate of the relative risk arising from AATD which may help guide clinicians and patients, and enable future comparisons to be made.”

To estimate the risk that COVID-19 poses to patients with severe AATD, a team of researchers led by Marc Miravitlles, MD, from the Department of Pneumology, Hospital Universitari Vall d’Hebron in Barcelona, Spain used data from the European alpha-1 research collaboration. They identified 105 patients with AATD across 21 centers in 10 countries who had COVID-19.

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The disease led to symptoms like worsening breathlessness, cough, loss of smell and taste, headache, muscle pain, and gastrointestinal symptoms. Almost one-third of patients were hospitalized due to COVID-19 for a mean period of 12.9 days with 5 needing intensive care for a mean duration of 5.6 days.

Read more about the etiology of AATD

The researchers reported that poor outcome was more frequent in patients with the PiZZ allele compared to those with the PiSZ allele. However, the difference was not statistically significant.

They also found that “non-respiratory comorbidities were more strongly associated with poor outcome than genotype, baseline FEV1, or oxygen saturation” and that it was less likely with symptoms of loss of smell or taste. Death occurred only in patients with the PiZZ allele who also had a reduction in FEV1% predicted, suggesting that the disease was progressing faster.

The authors concluded that patients with severe AATD should still take the necessary measure to reduce their risk of contracting COVID-19.


Parr DG, Chorostowska-Wynimko J, Corsico A, et al. Impact of COVID-19 in patients with severe alpha-1 antitrypsin deficiency: The IMCA1 study of the EARCO clinical research collaboration. Arch Bronconeumol. Published online July 11, 2022. doi:10.1016/j.arbres.2022.07.002