Immunometabolism at the cornerstone of inflammaging, immunosenescence, and autoimmunity in COVID-19

Omarjee, Loukman; Perrot, Frédérique; Meilhac, Olivier; Mahé, Guillaume; Bousquet, Guilhem; Janin, Anne

doi:10.18632/aging.202422

Cited by 31 publications

(24 citation statements)

References 102 publications

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“…The consequence of inflame-aging is deleterious effet to organ leading to a higher risk of mortality [21]. Consistent with other studies, our findings reported that patients with higher WBC count, NLR, PCT, D-Dimer, and CRP had higher odds of COVID-19 mortality [5,22,23].…”

Section: Discussionsupporting

confidence: 90%

Predictive accuracy of blood inflammatory markers on COVID-19 mortality

et al. 2021

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Background: The impact of COVID-19 may be more severe in developing countries. Our study aims to analyze the accuracy of several inflammatory biomarkers in predicting COVID-19 mortality, providing information about the most suitable markers for developing countries. Methods: A retrospective cohort study was conducted at Dr. Soetomo General Hospital, Indonesia, from March to June 2020. White Blood Cells (WBC) count, Neutrophil-Lymphocyte Ratio (NLR), Procalcitonin (PCT), D-Dimer, and C-Reactive Protein (CRP) have been collected from the electronic medical records. We performed survival analysis to provide the hazard ratio and Receiver Operating Characteristic (ROC) curve analysis to test for accuracy for each parameter. Results: A total of 423 patients who met the criteria for participating had a median age of 54 (IQR 45-61) years. Patients in the death group are characterized by older age and shorter length of hospitalization. The WBC, NLR, PCT, D-Dimer, and CRP are found significantly higher in the death group (P=0.000). The WBC, NLR, PCT, D-Dimer, and CRP have an Area Under the Curve (AUC) of 0.709, 0.773, 0.738, 0.721, and 0.769, respectively moderate accuracy in predicting COVID-19 patient mortality. We found that NLR is significantly more accurate than the age parameter (Z=3.527; P=0.000) but has equal accuracy with other laboratory parameters. Conclusions: Since NLR obtained the highest accuracy, we still recommend routine complete blood count tests as prognostic biomarkers with the highest feasibility to be performed in developing countries.

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Section: Discussionsupporting

confidence: 90%

Predictive accuracy of blood inflammatory markers on COVID-19 mortality

et al. 2021

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“…Also, it was demonstrated elevated production of INF ȣ by memory T cell from a cohort of MG patients and Th 22 cells, secreting TNF ɑ are increased in MG 19,20 . This is important to know since INF ȣ and TNF ɑ are two components of the cytokine storm observed in ARDS related to SARS‐CoV‐2 infection, 20,21 in addition to immunosenescence, that may contribute to ARDS 13,14 …”

Section: Discussionmentioning

confidence: 98%

Myasthenia gravis and COVID‐19: A case series and comparison with literature

Saied

Rachdi

Thamlaoui

et al. 2021

Acta Neuro Scandinavica

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Objective To describe presenting symptoms, clinical outcomes, and therapeutic management of concurrent Coronavirus disease 2019 (COVID‐19) infections in patients with a pre‐existing myasthenia gravis (MG). Methods We conducted a retrospective study in patients with preexisting MG presenting with concurrent COVID‐19 between September 21st and November 4th, 2020 when attending the emergency department or routine neurology consultation at the National Institute Mongi Ben Hamida of Neurology of Tunis, Tunisia. Results Five patients were identified. The Myasthenia Gravis Foundation of America scores (MGFA) prior to COVID‐19 infection were class I in one patient, class II (IIa, IIb) in two patients, and class IIIb in one patient. Four patients had mild to moderate courses of COVID‐19 infection. One patient presented a critical infection with acute respiratory disease syndrome (ARDS) requiring mechanical ventilation. Two of them also demonstrated signs of MG exacerbation requiring the use of intravenous immunoglobulin in one case. We maintained immunosuppressant therapy to MG in all our patients. All our patients received Azithromycin (AZM) as a part of specific drug treatment of COVID‐19 infection. Outcome was favorable in 4 patients and rapidly fatal evolution was observed in the patient with ADRS. Discussions and conclusion The results from our study suggest that prior MG activity could partially influence the subsequent clinical outcomes. It emerged also that ongoing long‐term immunosuppressive immunotherapy to MG should be maintained during the COVID‐19 pandemic and that AZM can be used safely in MG patients and concurrent COVID‐19 infection.

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“…Inflammaging has since been investigate a whole range of age-related diseases within the so-called “network theory of aging”. Recently, in the pandemic of coronavirus disease 2019 (COVID-19), inflammaging gained additional attention in view of the observed cytokine storm and autoimmunity during infection among older patients, which can result in multiple organ failure and is in general associated with a worse disease outcome [ 135 , 136 ] and of course potentially increases the risk for malnutrition, though data are lacking [ 137 ]. This severe systemic inundation of cytokines might be further triggered by the dysregulated immune system in old age (immunosenescence), which is expressed in an imbalanced homeostasis of pro- and anti-inflammatory mediators [ 135 ].…”

Section: Determinants Of Malnutritionmentioning

confidence: 99%

Malnutrition in Older Adults—Recent Advances and Remaining Challenges

2021

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Malnutrition in older adults has been recognised as a challenging health concern associated with not only increased mortality and morbidity, but also with physical decline, which has wide ranging acute implications for activities of daily living and quality of life in general. Malnutrition is common and may also contribute to the development of the geriatric syndromes in older adults. Malnutrition in the old is reflected by either involuntary weight loss or low body mass index, but hidden deficiencies such as micronutrient deficiencies are more difficult to assess and therefore frequently overlooked in the community-dwelling old. In developed countries, the most cited cause of malnutrition is disease, as both acute and chronic disorders have the potential to result in or aggravate malnutrition. Therefore, as higher age is one risk factor for developing disease, older adults have the highest risk of being at nutritional risk or becoming malnourished. However, the aetiology of malnutrition is complex and multifactorial, and the development of malnutrition in the old is most likely also facilitated by ageing processes. This comprehensive narrative review summarizes current evidence on the prevalence and determinants of malnutrition in old adults spanning from age-related changes to disease-associated risk factors, and outlines remaining challenges in the understanding, identification as well as treatment of malnutrition, which in some cases may include targeted supplementation of macro- and/or micronutrients, when diet alone is not sufficient to meet age-specific requirements.

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Immunometabolism at the cornerstone of inflammaging, immunosenescence, and autoimmunity in COVID-19

Cited by 31 publications

References 102 publications

Predictive accuracy of blood inflammatory markers on COVID-19 mortality

Predictive accuracy of blood inflammatory markers on COVID-19 mortality

Myasthenia gravis and COVID‐19: A case series and comparison with literature

Malnutrition in Older Adults—Recent Advances and Remaining Challenges

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