“…We observed a significant overlap between the interactors of SARS-CoV-2 and ageing group. Further, we looked at a network-level scenario [35], by considering possible regulatory mechanisms that may be altered [42,43]. These observations support previous reports that SARS-CoV-2 may manifest in the blood leading to multiorgan failure in severe cases of COVID-19.…”
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease, 2019; COVID-19) is associated with adverse outcomes in patients. It has been observed that lethality seems to be related to the age of patients. Moreover, it has been demonstrated that ageing causes some modifications at a molecular level.Objective The study aims to investigate a possible link between the increased COVID-19 lethality and the molecular changes that occur in elderly people.Methods We considered publicly available datasets on ageing-related genes and SARS-CoV-2 interactors. Then, for each SARS-CoV-2 protein interactor, we tested for the enrichment of ageing-related proteins. Finally, we performed a network-based analysis to identify which molecular mechanisms could play a role in the SARS-CoV-2 molecular aetiology and ultimately affect COVID-19 outcome.Results We observed a significant intersection between some SARS-CoV-2 interactors and ageing-related genes. Our analysis evidenced that virus infection particularly affects ageing molecular mechanisms centred around proteins EEF2, NPM1, HMGA1, HMGA2, APEX1, CHEK1, PRKDC, and GPX4.Conclusion Our study generated a mechanistic framework aiming at explaining the correlation between COVID-19 incidence in elderly patients and molecular mechanisms of ageing. This will provide testable hypotheses for future investigation on the mechanism of action of coronaviruses and pharmacological solutions tailored on specific age ranges.
“…We observed a significant overlap between the interactors of SARS-CoV-2 and ageing group. Further, we looked at a network-level scenario [35], by considering possible regulatory mechanisms that may be altered [42,43]. These observations support previous reports that SARS-CoV-2 may manifest in the blood leading to multiorgan failure in severe cases of COVID-19.…”
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease, 2019; COVID-19) is associated with adverse outcomes in patients. It has been observed that lethality seems to be related to the age of patients. Moreover, it has been demonstrated that ageing causes some modifications at a molecular level.Objective The study aims to investigate a possible link between the increased COVID-19 lethality and the molecular changes that occur in elderly people.Methods We considered publicly available datasets on ageing-related genes and SARS-CoV-2 interactors. Then, for each SARS-CoV-2 protein interactor, we tested for the enrichment of ageing-related proteins. Finally, we performed a network-based analysis to identify which molecular mechanisms could play a role in the SARS-CoV-2 molecular aetiology and ultimately affect COVID-19 outcome.Results We observed a significant intersection between some SARS-CoV-2 interactors and ageing-related genes. Our analysis evidenced that virus infection particularly affects ageing molecular mechanisms centred around proteins EEF2, NPM1, HMGA1, HMGA2, APEX1, CHEK1, PRKDC, and GPX4.Conclusion Our study generated a mechanistic framework aiming at explaining the correlation between COVID-19 incidence in elderly patients and molecular mechanisms of ageing. This will provide testable hypotheses for future investigation on the mechanism of action of coronaviruses and pharmacological solutions tailored on specific age ranges.
“… 6 , 20 , 21 However, it contrasts with the 22.4% shown in a coordinated on-site medicalization program conducted in 4 care homes of Seville with 272 residents, where only 23.5% of patients were hospitalized, suggesting that the population did not present forms of COVID-19 as severe as ours. 22 Moreover, according to preliminary results, approximately 60% of the older population living in care facilities in Madrid have humoral immunity to SARS-CoV-2, implying that approximately 2500 residents in our area of influence would have been affected by COVID-19. 23 These data suggest that we may have attended more severe cases and, therefore, with worse prognosis.…”
Background
COVID-19 outbreaks in aged care facilities (ACFs) often have devastating consequences. However, epidemiologically these outbreaks are not well defined. We aimed to define such outbreaks in ACFs by systematically reviewing literature published during the current COVID-19 pandemic.
Methods
We searched 11 bibliographic databases for literature published on COVID-19 in ACFs between December 2019 and September 2020. Original studies reporting extractable epidemiological data as part of outbreak investigations or non-outbreak surveillance of ACFs were included in this systematic review and meta-analysis. PROSPERO registration: CRD42020211424.
Findings
We identified 5,148 publications and selected 49 studies from four continents reporting data on 214,380 residents in 8,502 ACFs with 25,567 confirmed cases of COVID-19. Aged care residents form a distinct vulnerable population with single-facility attack rates of 45% [95% CI 32–58%] and case fatality rates of 23% [95% CI 18–28%]. Of the cases, 31% [95% CI 28–34%] were asymptomatic. The rate of hospitalization amongst residents was 37% [95% CI 35–39%]. Data from 21 outbreaks identified a resident as the index case in 58% of outbreaks and a staff member in 42%. Findings from the included studies were heterogeneous and of low to moderate quality in risk of bias assessment.
Interpretation
The clinical presentation of COVID-19 varies widely in ACFs residents, from asymptomatic to highly serious cases. Preventing the introduction of COVID-19 into ACFs is key, and both residents and staff are a priority group for COVID-19 vaccination. Rapid diagnosis, identification of primary and secondary cases and close contacts plus their isolation and quarantine are of paramount importance.
Funding
Queensland Advancing Clinical Research Fellowship awarded to Prof. Gulam Khandaker by Queensland Health's Health Innovation, Investment and Research Office (HIRO), Office of the Director-General.
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