July 2021
Aging-US published "Why does COVID-19 disproportionately affect older people?" which reported that the severity and outcome of coronavirus disease 2019 largely depends on a patient’s age.
Adults over 65 years of age represent 80% of hospitalizations and have a 23-fold greater risk of death than those under 65. In the clinic, COVID-19 patients most commonly present with fever, cough and dyspnea, and from there the disease can progress to acute respiratory distress syndrome, lung consolidation, cytokine release syndrome, endotheliitis, coagulopathy, multiple organ failure and death.
Comorbidities such as cardiovascular disease, diabetes and obesity increase the chances of fatal disease, but they alone do not explain why age is an independent risk factor.
The authors also discuss several biological age clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease and individuals most at risk.
Finally, based on these mechanisms, they discuss treatments that could increase the survival of older people, not simply by inhibiting the virus, but by restoring patients’ ability to clear the infection and effectively regulate immune responses.
Dr. David A. Sinclair, Professor of Pathology and Co-Director of the Glenn Laboratories for Aging Research at Harvard Medical School as well as Co-Editor-in-Chief of Aging-US and Dr. Amber L. Mueller, also from Glenn Center for Biology of Aging Research, Blavatnik Institute, Harvard Medical School, said, "Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the worldwide pandemic of coronavirus disease (COVID-19) originated in Wuhan, China, in late 2019."
COVID-19 has (at the time of this study) killed more than 350,000 people, with the majority of deaths occurring in people over the age of 65.
For example, simple explanations for the impact of age that are based solely on co-morbidities or on a general lack of resilience in aging, for example, fail to explain why the immune system often reacts uncontrollably.
Particularly in older people, severe cases of the disease are characterized by acute lung injury and ARDS, the latter of which is typically treated by positive airway pressure with oxygen and pronation or invasive ventilation.
In this perspective, the authors offer potential mechanistic explanations as to why COVID-19 advances in some people and not others, and especially in older patients, including differences in the immune system, glycation, the epigenome, inflammasome activity, and biological age.
They also discuss therapies that may improve immunity against viral infection while enhancing the ability of older people to recover from severe COVID-19.
The Sinclair/Mueller Research Team conclude in their Aging-US Research Output that besides understanding the basis of the cytokine storms and coagulopathy, it is not known why SARS-CoV-2 so easily damages such a broad array of tissues in older people but rarely in the young.
Nor is it clear whether older people develop stronger or weaker functional immunity during seroconversion, or how long their protection will last compared to younger people.
Therefore, in designing vaccines against SARS-CoV-2, it will be important to consider that older people may not respond as well to vaccines as young people.
Studies that follow the long-term consequences of SARS-CoV-2 infection in older people will also be critical to understand the long-term health consequences of COVID-19 pathology, such as fibrosis and scarring of the lungs, micro-ischemic events, cardiopulmonary dysfunction, and neuropsychological disability.
These could significantly reduce viral resistance and lifespan in older and middle-aged people who recover from severe cases of COVID-19. The most exciting and potentially impactful technologies to combat COVID-19 and other viral pandemics are those that activate the body’s defenses against aging.
DOI - https://doi.org/10.18632/aging.103344
Full Text - https://www.aging-us.com/article/1033...
Correspondence to: Amber L. Mueller email: amber_mueller@hms.harvard.edu and David A. Sinclair email: david_sinclair@hms.harvard.edu
Keywords: aging, cytokine storm, COVID-19, epigenetic clock, immunity
About Aging-US
Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research as well as topics beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, cancer, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR among others), and approaches to modulating these signaling pathways.
To learn more about Aging-US, please visit http://www.Aging-US.com or connect with @AgingJrnl
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