Older patients affected by COVID-19: investigating the existence of biological phenotypes.

Autor: Zucchelli A; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, 171 77, Sweden. alberto.zucchelli.1@ki.se.; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. alberto.zucchelli.1@ki.se., Parigi M; A. Nocivelli Institute for Molecular Medicine, ASST Spedali Civili, Brescia, Italy.; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy., Giliani S; A. Nocivelli Institute for Molecular Medicine, ASST Spedali Civili, Brescia, Italy.; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy., Vetrano DL; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, 171 77, Sweden.; Stockholm Gerontology Research Center, Stockholm, Sweden., Lucente D; Fondazione 'Ospedale e Casa di Riposo Nobile Paolo Richiedei', Brescia, Italy., Marzetti E; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.; Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy., Calvani R; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.; Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy., Bellelli G; School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy.; Acute Geriatric Unit, IRCCS San Gerardo Foundation, Monza, Italy., Marengoni A; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, 171 77, Sweden.; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2024 Nov 07; Vol. 24 (1), pp. 923. Date of Electronic Publication: 2024 Nov 07.
DOI: 10.1186/s12877-024-05473-5
Abstrakt: Introduction: COVID-19 provides an opportunity to examine biological phenotypes (observable morphological, functional and biological characteristics) in individuals who experience the same acute condition, potentially revealing differences in response to acute external stressors. The aim our study was to investigate biological phenotypes in older patients hospitalized for COVID-19, exploiting a panel of aging biomarkers.
Methods: Data were gathered from the FRACOVID Project, an observational multicenter study, aimed to evaluate the impact of frailty on health-related outcomes in patients 60 + with COVID-19 in Northern Italy. A hierarchical cluster analysis was run using log-transformed and scaled values of TNF-a, IL-1 beta, IL-6, PAI-1, GDF-15, NT-proBNP, and Cystatin C evaluated at admission.
Results: Eighty-one participants (mean age 75.3 years; 60.5% male) were evaluated. Frailty was identified in 42% of the sample and 27.2% were unable to ambulate outdoors. The mean hospital stay was 24.7 days, with an in-hospital mortality rate of 18.5%. Three biological phenotypes were found: (1) 'inflammatory', with high inflammatory biomarkers; (2) 'organ dysfunction', characterized by elevated cystatin C and NT-proBNP, and lower inflammatory markers; and (3) 'unspecific', with lower NT-proBNP and GDF-15 levels, and intermediate concentrations of other biomarkers. The 'organ dysfunction' phenotype showed the highest mean age and prevalence of frailty, disability, and chronic diseases. The 'inflammatory' phenotype showed the highest burden of respiratory and systemic signs and symptoms of infection.
Conclusion: Biological phenotypes might be used to identify different clinical and functional phenotypes in individuals affected by COVID-19.
(© 2024. The Author(s).)
Databáze: MEDLINE
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