{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:14:19Z","timestamp":1789820059234,"version":"4.0.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We have previously found using questionnaire\/interview data on COVID-19 outcomes, that most subjects with severe alpha-1-antitrypsin deficiency (AATD) exhibit mild COVID-19 infection and those who additionally have COPD are at increased risk of severe COVID-19. We used objective information on COVID-19 outcomes in severe AATD (PiZZ) from the Swedish population and compared the risk of severe COVID-19 in severe AATD to the risk of severe COVID-19 in the general population. We cross-linked the Swedish National AATD Registry with the Swedish National Patient Register to identify subjects with severe AATD that required COVID-19-related hospitalization between March 2020 until June 2023. Standardised incidence ratio (SIR) was calculated using observed COVID-19 hospitalisations in severe AATD and expected COVID-19 hospitalisations from the general population. Logistic regression was used to calculate odds of moderate or severe COVID-19 in severe AATD in relation to pre-existing comorbidities. In 1228 subjects with severe AATD, there were 61 cases of COVID-19-related hospitalisations (severe COVID-19) and 32 moderate COVID-19 during follow-up. The observed hospitalizations for COVID-19 in subjects with severe AATD exceeded that expected in the general population by over threefold (SIR\u2009=\u20093.4). Odds of COVID-19 was elevated in subjects with severe AATD with COPD or CVD (OR 2.70 (1.52\u20134.80) and 3.51 (2.04\u20136.06), respectively. The majority of subjects with severe AAT deficiency had mild COVID-19 during the pandemic. Of subjects that did have severe COVID-19, pre-existing co-morbidities were common, potentially explaining the higher rate of COVID-19 hospitalisations in severe AATD relative to the general population.<\/jats:p>","DOI":"10.1038\/s41598-026-35016-4","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T09:04:24Z","timestamp":1768208664000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["COVID-19 outcomes in individuals with severe alpha-1 antitrypsin deficiency in Sweden"],"prefix":"10.1038","volume":"16","author":[{"given":"Suneela","family":"Zaigham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eeva","family":"Piitulainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Tanash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"11","key":"35016_CR1","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1093\/gerona\/glaa183","volume":"75","author":"JL Atkins","year":"2020","unstructured":"Atkins, J. L. et al. Preexisting comorbidities predicting COVID-19 and mortality in the UK biobank community cohort. J. Gerontol. A Biol. Sci. Med. Sci. 75(11), 2224\u20132230 (2020).","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"issue":"10","key":"35016_CR2","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1001\/jamainternmed.2020.3539","volume":"180","author":"G Grasselli","year":"2020","unstructured":"Grasselli, G. et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in lombardy. Italy. JAMA Intern. Med. 180(10), 1345\u20131355 (2020).","journal-title":"Italy. JAMA Intern. Med."},{"issue":"4","key":"35016_CR3","doi-asserted-by":"publisher","first-page":"e228109","DOI":"10.1001\/jamanetworkopen.2022.8109","volume":"5","author":"Z Yu","year":"2022","unstructured":"Yu, Z. et al. Association of short-term air pollution exposure with SARS-CoV-2 infection among young adults in Sweden. JAMA Netw. 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Well-known and less well-known functions of alpha-1 antitrypsin its role in chronic obstructive pulmonary disease and other disease developments. Ann. Am. Thorac. Soc. 13(4), 280\u2013288 (2016).","journal-title":"Ann Am Thorac Soc"},{"key":"35016_CR7","doi-asserted-by":"crossref","unstructured":"Azouz NP, Klingler AM, Callahan V, Akhrymuk IV, Elez K, Raich L, et al. Alpha 1 antitrypsin is an inhibitor of the SARS-CoV-2-Priming Protease TMPRSS2. bioRxiv. (2020).","DOI":"10.1101\/2020.05.04.077826"},{"issue":"2","key":"35016_CR8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.35772\/ghm.2020.01068","volume":"3","author":"H Yoshikura","year":"2021","unstructured":"Yoshikura, H. Epidemiological correlation between COVID-19 epidemic and prevalence of \u03b1-1 antitrypsin deficiency in the world. 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The study was carried out according to the principles of the Declaration of Helsinki. All individuals included in the Swedish National AATD Registry had provided written informed consent at the time of inclusion, including consent for collection of data from medical records and national patient registers for research purposes. The present study represents a retrospective analysis of fully anonymised registry data conducted within the scope of this original consent. The present study was approved by the Regional Ethical Review Board, Lund, Sweden and Swedish Ethical Review Authority (2014\/427and 2020\u201303,814).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The authors report no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts interest"}}],"article-number":"1616"}}