Table 1.

Clinical characteristics of patients and unaffected carriers of COPA mutations

Affected patientsUnaffected carriersP value
General, #/n (%)    
 Alive 19/26 (73%) 8/9 (89%)  
 Female sex 17/26 (65%) 5/9 (56%)  
 Died from respiratory failure 7/7 (100%) 0/1 (0%)  
Age in years, median (range; n   
 Symptom onset 2 (0.3–18; n = 23) n/a P < 0.0001 
 Symptom onset ≤5, #/n (%) 19/23 (83%) 0/9 (0%)  
 Last clinical evaluation 26.5 (2.5–59; n = 26) 60 (41–78; n = 9)  
 Death 36 (2.5–49; n = 7) 69 (69–69; n = 1) P = 0.019 
Presenting symptoms, #/n (%)    
 Tachypnea, cough, and hemoptysis 19/25 (76%) n/a  
 Joint pain 10/25 (40%) n/a  
 Failure to thrive 15/25 (60%) n/a  
Autoantibodies, #/n (%) 19/19 (100%) 2/6 (33%) P = 0.0012 
 ANA 17/19 (89%) 2/6 (33%)  
 ANCA (immunofluorescence, MPO, or PR3) 12/19 (63%) 1/6 (17%)  
 RF or CCP 8/17 (47%) 1/4 (25%)  
Pulmonary involvement, #/n (%) 24/24 (100%) 0/9 (0%) P < 0.0001 
 Dyspnea, cough, and exercise intolerance 23/24 (96%) 0/9 (0%)  
 Hemoptysis or alveolar hemorrhage 12/22 (55%) 0/9 (0%)  
 COPA syndrome features on chest imaging 23/23 (100%) 0/6 (0%)  
 Lung transplant 5/24 (21%) n/a  
Musculoskeletal involvement, #/n (%) 19/22 (86%) 0/9 (0%) P < 0.0001 
 Inflammatory arthritis 15/21 (71%) 0/9 (0%)  
 Other 7/11 (64%) 0/9 (0%)  
Renal involvement, #/n (%) 9/19 (47%) 0/7 (0%) P = 0.0578 
 Nephritis 8/19 (42%) 0/5 (0%)  
 Proteinuria 5/16 (31%) 0/4 (0%)  
 Reduced glomerular filtration rate 2/17 (12%) 0/7 (0%)  
Chronic immunosuppression, #/n (%) 23/23 (100%) 0/9 (0%) P < 0.0001 
Affected patientsUnaffected carriersP value
General, #/n (%)    
 Alive 19/26 (73%) 8/9 (89%)  
 Female sex 17/26 (65%) 5/9 (56%)  
 Died from respiratory failure 7/7 (100%) 0/1 (0%)  
Age in years, median (range; n   
 Symptom onset 2 (0.3–18; n = 23) n/a P < 0.0001 
 Symptom onset ≤5, #/n (%) 19/23 (83%) 0/9 (0%)  
 Last clinical evaluation 26.5 (2.5–59; n = 26) 60 (41–78; n = 9)  
 Death 36 (2.5–49; n = 7) 69 (69–69; n = 1) P = 0.019 
Presenting symptoms, #/n (%)    
 Tachypnea, cough, and hemoptysis 19/25 (76%) n/a  
 Joint pain 10/25 (40%) n/a  
 Failure to thrive 15/25 (60%) n/a  
Autoantibodies, #/n (%) 19/19 (100%) 2/6 (33%) P = 0.0012 
 ANA 17/19 (89%) 2/6 (33%)  
 ANCA (immunofluorescence, MPO, or PR3) 12/19 (63%) 1/6 (17%)  
 RF or CCP 8/17 (47%) 1/4 (25%)  
Pulmonary involvement, #/n (%) 24/24 (100%) 0/9 (0%) P < 0.0001 
 Dyspnea, cough, and exercise intolerance 23/24 (96%) 0/9 (0%)  
 Hemoptysis or alveolar hemorrhage 12/22 (55%) 0/9 (0%)  
 COPA syndrome features on chest imaging 23/23 (100%) 0/6 (0%)  
 Lung transplant 5/24 (21%) n/a  
Musculoskeletal involvement, #/n (%) 19/22 (86%) 0/9 (0%) P < 0.0001 
 Inflammatory arthritis 15/21 (71%) 0/9 (0%)  
 Other 7/11 (64%) 0/9 (0%)  
Renal involvement, #/n (%) 9/19 (47%) 0/7 (0%) P = 0.0578 
 Nephritis 8/19 (42%) 0/5 (0%)  
 Proteinuria 5/16 (31%) 0/4 (0%)  
 Reduced glomerular filtration rate 2/17 (12%) 0/7 (0%)  
Chronic immunosuppression, #/n (%) 23/23 (100%) 0/9 (0%) P < 0.0001 

Chest imaging refers to computed tomography scans except for one unaffected carrier with plain a chest radiograph. Autoantibody titer of 1:80 or higher are considered positive for ANA. Lung transplants include one patient with combined heart–lung transplant and one patient with redo lung transplantation. Nephritis defined by hematuria, excluding known nephrolithiasis or diagnosis on biopsy. Other musculoskeletal involvement includes arthralgias, myalgias, avascular necrosis, or need for orthopedic surgery, except when indication was trauma. Proteinuria defined as two or more instances of urine protein creatinine ratio >1. Reduced glomerular filtration rate defined as ≤60. Statistical analysis performed by log-rank test for ages at symptom onset and death or by Fisher exact test for various disease manifestations. ANA = antinuclear antibody; ANCA = antineutrophil cytoplasmic antibody; MPO = myeloperoxidase antibody; PR3 = proteinase 3 antibody; RF = Rheumatoid Factor; CCP = anti-cyclic citrullinated peptide antibody.

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