A distinct association of inflammatory molecules with outcomes of COVID-19 in younger versus older adults.

Autor: Shin JJ; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Jeon S; Yale University School of Nursing, West Haven, CT 06516, USA., Unlu S; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Par-Young J; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Shin MS; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Kuster JK; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Afinogenova Y; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Kang Y; Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT 06610, United States of America., Simonov M; Clinical and Translational Research Accelerator (CTRA), Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Buller G; Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT 06610, United States of America., Bucala R; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA., Kang I; Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA. Electronic address: Insoo.kang@yale.edu.
Jazyk: angličtina
Zdroj: Clinical immunology (Orlando, Fla.) [Clin Immunol] 2021 Nov; Vol. 232, pp. 108857. Date of Electronic Publication: 2021 Sep 22.
DOI: 10.1016/j.clim.2021.108857
Abstrakt: Aging can alter immunity affecting host defense. COVID-19 has the most devastating clinical outcomes in older adults, raising the implication of immune aging in determining its severity and mortality. We investigated biological predictors for clinical outcomes in a dataset of 13,642 ambulatory and hospitalized adult COVID-19 patients, including younger (age < 65, n = 566) and older (age ≥ 65, n = 717) subjects, with in-depth analyses of inflammatory molecules, cytokines and comorbidities. Disease severity and mortality in younger and older adults were associated with discrete immune mechanisms, including predominant T cell activation in younger adults, as measured by increased soluble IL-2 receptor alpha, and increased IL-10 in older adults although both groups also had shared inflammatory processes, including acute phase reactants, contributing to clinical outcomes. These observations suggest that progression to severe disease and death in COVID-19 may proceed by different immunologic mechanisms in younger versus older subjects and introduce the possibility of age-based immune directed therapies.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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