Spanish pulmonologists reveal that alpha-1 antitrypsin deficiency increases severity and mortality in patients with Covid-19

2023-04-24 16:55:27

A multicenter study promoted and coordinated by pulmonologists from the Hospital Clínico San Carlos in Madrid has revealed that in patients diagnosed with COVID-19 and alpha-1 antitrypsin deficiency (a congenital disease that can cause pulmonary emphysema) infection by SARS-CoV- 2 increases severity and mortality.

In the research, known as ‘COVID-19 DAAT’ and published in the scientific journal ‘Biomedicines’, they have participated 2,022 patients with confirmed diagnosis of SARS-CoV-2 infection in the laboratory, and has been developed from May 2021 to September 2022 with the participation of nine Spanish health centers.

Research has revealed that factors such as being a man, elderly, smokerwith comorbidities and alpha-1 antitrypsin deficiency are associated with a higher probability of severe COVID-19 infection.

The objective of the study was to evaluate whether the data on higher mortality from COVID-19, detected in regions with a higher prevalence of this alpha-1 antitrypsin deficiencycould be related to a poor prognostic factor in SARS-CoV-2 infection.

“The results have confirmed our hypothesis that these patients, with a positive diagnosis of COVID-19, they are more vulnerablesince having alpha-1 antitrypsin deficiency increases the severity and mortality of SARS-CoV-2 infection”, explained Juan Luis Rodríguez Hermosa, coordinator of the study and pulmonologist at Hospital Clínico San Carlos.

Congenital disease

Alpha-1 antitrypsin deficiency is a genetic condition that increases the risk of suffering respiratory and liver diseasesand is generated because the body does not produce enough of this protein, which protects the lung of aggressions caused by external agents such as tobacco or other inhaled substances that are polluting and irritating.

It is a congenital disease that has a higher prevalence than pulmonary hypertension or cystic fibrosis, which also affects patients with COPD, and which can cause the development of pulmonary emphysema and liver disease.

The pulmonologists at the Hospital Clínico San Carlos have been developing a respiratory rehabilitation program called ‘Walk and breathe’, which consists of performing weekly walks for six monthswith groups of six patients, in whom, while walking outdoors, they carry out respiratory physiotherapy exercises, guided by a physiotherapist and a nurse.

The patients, whom a pedometer is provided and bracelets that monitor their activity, depart from the Clinical Hospital to the Moncloa lighthouse, returning back to the hospital.

During their journey they make several stops for the carrying out the exercisesamong which is the stop to visit the Museum of America as part of the humanization and respiratory rehabilitation program.

In addition, the Hospital Clínico San Carlos has an alpha-1 antitrypsin deficiency unit accredited as center of excellence by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), and which is made up of pulmonologists, physiotherapists, nursing professionals, nutritionists, experts in the digestive system and genetics.

Thus, they offer comprehensive care with actions such as augmentative therapywhich prevents the progression of the disease, together with a genetic study and the evaluation of blood relatives to rule out this deficiency as a risk factor for other lung diseases such as COPD.