Abstract
Background: Cell entry of coronaviruses depends on the viral spike S protein priming by the serine protease TMPRSS2. A protease-antiprotease imbalance, in particular deficiency of Alpha1-Antitrypsin (AAT), could play a central role in the virulence of SARS-CoV-2 (Vianello A and Braccioni F. Arch Bronconeumol. 2020;56:609-10).
Aims and objecives: To investigate the prevalence of AAT deficiency (AATD) among adult patients with ARDS consequent to SARS-CoV-2 infection.
Methods: Subjects who recovered from ARDS (group A) and/or from mild illness (group B) consequent to SARS-CoV-2 infection were tested for circulating AAT concentration at 3-month follow-up. AATD was defined according to national reference values (plasma concentration < 113mg/dL) (Gorrini M, et al. Clin Chem. 2006;52:899-901). Complete testing for AATD, including isoelectric focusing and genotyping of the pathological alleles, was conducted in subjects with abmormally low plasma concentration.
Results: 83 patients were tested. Compared to group B, group A showed a higher proportion of deficient cases (12/59 vs 1/24; p=0.06) and a trend toward lower plasma AAT concentration [127 (83-198) vs 132 (107-166) mg/dL; p=0.19]. 5/12 deficient patients in group A presented an abnormal genotypic variant of AAT.
Conclusions: the prevalence of AATD is increased in patients who developed ARDS consequent to SARS-CoV-2 infection. The potential role of AAT in limiting the virulence of SARS-CoV-2 needs further investigation.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA812.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021
