<scp>COVID</scp>‐19 and Older Adults: What We Know

Shahid, Zainab; Kalayanamitra, Ricci; McClafferty, Brendan; Kepko, Douglas; Ramgobin, Devyani; Patel, Ravi; Aggarwal, Chander Shekher; Vunnam, Rama; Sahu, Nitasa; Bhatt, Dhirisha; Jones, Kirk D.; Golamari, Reshma; Jain, Rohit

doi:10.1111/jgs.16472

Cited by 858 publications

(852 citation statements)

References 26 publications

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“…The immunomodulatory therapy was administered shortly after the contagion. In addition to the advance age, all moderately ill patients suffered with comorbidities, which are both risk factors associated with severity and fatal outcome in the course of COVID-19 [30,31]. Therefore, we suggest that the stabilization of the IL-6 levels over low values was due to the treatment with itolizumab.…”

Section: Discussionmentioning

confidence: 90%

An Anti-CD6 Monoclonal Antibody (Itolizumab) Reduces Circulating IL-6 in Severe Covid-19 Elderly Patients

Saavedra¹,

Añé-Kourí

Sánchez³

et al. 2020

Preprint

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Background: Since the COVID-19 outbreak an unprecedented challenge for healthcare systems around the world has been placed. In Cuba, the first case of COVID-19 was reported on March 11. Elderly with multiple comorbidities have been the most risky population. Although most patients present a mild to moderate disease, some have developed severe symptoms. One of the possible mechanisms underlying rapid disease progression is a cytokine storm, in which interleukin (IL) -6 seems to be a major mediator. Itolizumabis a humanized recombinant anti-CD6 monoclonal antibody(MAb), with the ability of reducingserum interferon gamma(INF-γ), tumournecrosis factor alpha(TNFα) and IL-6. Based on these previous results in patients with psoriasis and rheumatoid arthritis, an expanded access clinical trial was approved by the Cuban regulatory agency for COVID-19 critically, severely and moderately ill patients. Results: We show here a short kinetic of IL-6 serum concentration in the first 24 COVID-19 patients treated with itolizumab. Most of patients were elderly with multiple comorbidities.We found that with one itolizumabdose, the circulating IL-6 decreased in critically and severely ill patients, whereas in moderately ill patients the values didn’trise as compared to theirlow baseline levels.Conclusion: These findings suggest that itolizumabcould be an attractive therapeutic option to decrease the negative outcome of the cytokine storm in COVID-19 patients.Trial registration: CECMED IIC RD-EC 179, RPCEC00000311. Registered 4May 2020 - Retrospectively registered, http://rpcec.sld.cu/ensayos/RPCEC00000311-Sp or http://rpcec.sld.cu/trials/RPCEC00000311-En

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Section: Discussionmentioning

confidence: 90%

An Anti-CD6 Monoclonal Antibody (Itolizumab) Reduces Circulating IL-6 in Severe Covid-19 Elderly Patients

Saavedra¹,

Añé-Kourí

Sánchez³

et al. 2020

Preprint

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“…Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers are commonly used in many adults with hypertension, diabetes, and chronic kidney disease [26]. Studies have shown that these drugs up-regulate ACE-2 receptors, which are the receptors that SARS-CoV-2 virus uses to enter host cells, which may be one of the reasons why older people with comorbidities are susceptible to infection and deterioration [27]. In addition, COVID-19 damage to the lungs can aggravate some comorbidities, such as chronic obstructive pulmonary disease.…”

Section: Covid-19 Patients With Comorbidities Were Also Likely To Shomentioning

confidence: 99%

Clinical characteristics of 276 hospitalized patients with coronavirus disease 2019 in Zengdu District, Hubei Province: A single-center descriptive study

Wei

Zeng

Huang

et al. 2020

Preprint

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Background We aimed to report the epidemiological and clinical characteristics of hospitalized patients with coronavirus disease-19 (COVID-19) in Zengdu District, Hubei Province, China.Methods Epidemiological,clinical features, laboratory findings, radiologic manifestations, and clinical outcomes of 276 patients in Zengdu hospital were analyzed. Clinical outcomes were followed up to March 13, 2020.Results All hospitalized COVID-19 patients, 276 (median age: 51.0 years), were enrolled, including 262 non-severe and 14 severe patients. The proportion of patients aged over 60 years was higher in the severe group (78.6%) than in the non-severe group (18.7%, p < 0.01). Some patients had comorbidities (31.9% [88/276]), the proportion was higher in the severe group (85.7%) than in the non-severe group (29.0%, p < 0.01). Common symptoms included fever (82.2% [227/276]) and cough (78.0% [218/276]). Most patients (94.9% [204/276]) were cured and discharged; 3.6% (10/276) deteriorated to a critical condition and were transferred to another hospital. The median COVID-19 treatment duration and hospital stay were 14.0 and 18.0 days, respectively.Conclusions COVID-19 patients in the areas surrounding Wuhan mainly showed mild and typical symptoms, Older patients or those with underlying comorbidities were at higher risk of deteriorating to a critical condition. In addition, we found that it takes about 14 days for nucleic acid test to turn negative in non-severe patients after antiviral treatment.

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“…Public health data from the European populations studied here was searched regarding the most common COVID-19 comorbidities reported. Aging has been broadly identified as the main one [13,20,21], followed by cardiovascular disease (CVD), diabetes, chronic obstructive pulmonary disease (COPD) and cancer history [13,15]. Liver dysfunction, smoking status, chronic kidney diseases and immunodeficiency have also been reported [14][15][16].…”

Section: Mortality Rate Frequency Calculationmentioning

confidence: 99%

Genes associated with liver damage signalling pathways may impact the severity of COVID-19 symptoms in Spanish and Italian populations

Moya

Farashi

Suravajhala

et al. 2020

Preprint

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AbstractAimThe novel SARS-CoV-2 virus, which causes the COVID-19 disease, has infected more than 10 million people and caused 500K deaths worldwide. In Europe, over 2 million confirmed cases have been reported, while nearly 200K people have died from the disease. Despite strict containment measures in Spain and Italy after the first reported COVID-19 patient, these two countries have remained in the top five European nations with the highest mortality rate for over two months. We hypothesised that a genetic mechanism could partially explain the poor survival outcome observed in these two countries.MethodsAn extensive literature search to identify human candidate genes linked to SARS-CoV infection, host immune evasion and disease aggressiveness was carried out. Pathway analysis (IPA) was performed to select the most significantly associated canonical signalling pathways with the genes of interest. The genetic variants’ at these genes with ±1Mb flanking region was extracted (GRCh37/hg19 built). Over 80 million single nucleotide polymorphisms (SNPs) were analysed in genome-wide data of 2,504 individuals (1000 genomes, phase III, https://www.internationalgenome.org/). Principal component (PC) analysis was performed, ancestry by the whole genome was inferred and subsets of the regions of interest were extracted (PLINK v1.9b, http://pngu.mgh.harvard.edu/purcell/plink/). PC1 to PC20 values from five European ancestries, including the Spanish and Italian populations, were used for PC analysis. Gene function predictions were run with our genes of interest as a query to the GeneMANIA Cytoscape plugin (https://genemania.org/).ResultsA total of 437 candidate genes associated with SARS were identified, including 21 correlated with COVID-19 aggressiveness. The two most significant pathways associated with all 437 genes (Caveolar-mediated Endocytosis and MSP-RON Signalling) did not show any segregation at the population level. However, the most significant canonical pathway associated with genes linked to COVID-19 aggressiveness, the Hepatic Fibrosis and Hepatic Stellate Cell Activation, showed population-specific segregation. Both the Spanish and Italian populations clustered together from the rest of Europe. This was also observed for the Finnish population but in the opposite direction. These results suggest some of the severe COVID-19 cases reported in Spain and Italy could be partially explained by a pre-existing liver condition (especially liver cancer) and/or may lead to further COVID-19 related liver complications.

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COVID‐19 and Older Adults: What We Know

Cited by 858 publications

References 26 publications

An Anti-CD6 Monoclonal Antibody (Itolizumab) Reduces Circulating IL-6 in Severe Covid-19 Elderly Patients

An Anti-CD6 Monoclonal Antibody (Itolizumab) Reduces Circulating IL-6 in Severe Covid-19 Elderly Patients

Clinical characteristics of 276 hospitalized patients with coronavirus disease 2019 in Zengdu District, Hubei Province: A single-center descriptive study

Genes associated with liver damage signalling pathways may impact the severity of COVID-19 symptoms in Spanish and Italian populations

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