While it is difficult to reconcile these incongruent findings between AAT anomalies and hospitalized COVID-19 cases, one plausible explanation is that some with known AAT deficiency took greater precautions as evinced by the finding that the AlphaNet (AAT-deficient) population had lower case rate but greater hospitalization rate for COVID-19 during the survey period from January 2020 to February 2022 [68]. The gene discussed is SERPINA1; the disease is hyperinsulinemic hypoglycemia, familial, 4.