The Aging Lung

Bowdish, Dawn M. E.

doi:10.1016/j.chest.2018.09.003

Cited by 59 publications

(24 citation statements)

References 120 publications

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“… 16 19–22 This observation also holds true for previous epidemic or pandemic outbreaks, such as SARS and Middle East respiratory syndrome where, as in COVID-19, the respiratory system is both the entry route and the main target of viral infection. 23 24 We could argue that lung senescence, resulting in decreased elasticity, increased end-expiratory lung volume and disrupted alveolar integrity, 25 together with kidney senescence, 26 may predispose per se to SARS-CoV-2-related acute respiratory and renal failure even in otherwise relatively robust elderly individuals. This hypothesis is consistent with the observation that age and three functional indicators of target organs (respiratory rate, PaO 2 /FiO 2 and serum creatinine) emerged as independent predictors of in-hospital mortality, after adjusting for comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study

et al. 2020

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ObjectivesSeveral physiological abnormalities that develop during COVID-19 are associated with increased mortality. In the present study, we aimed to develop a clinical risk score to predict the in-hospital mortality in COVID-19 patients, based on a set of variables available soon after the hospitalisation triage.SettingRetrospective cohort study of 516 patients consecutively admitted for COVID-19 to two Italian tertiary hospitals located in Northern and Central Italy were collected from 22 February 2020 (date of first admission) to 10 April 2020.ParticipantsConsecutive patients≥18 years admitted for COVID-19.Main outcome measuresSimple clinical and laboratory findings readily available after triage were compared by patients’ survival status (‘dead’ vs ‘alive’), with the objective of identifying baseline variables associated with mortality. These were used to build a COVID-19 in-hospital mortality risk score (COVID-19MRS).ResultsMean age was 67±13 years (mean±SD), and 66.9% were male. Using Cox regression analysis, tertiles of increasing age (≥75, upper vs <62 years, lower: HR 7.92; p<0.001) and number of chronic diseases (≥4 vs 0–1: HR 2.09; p=0.007), respiratory rate (HR 1.04 per unit increase; p=0.001), PaO2/FiO2 (HR 0.995 per unit increase; p<0.001), serum creatinine (HR 1.34 per unit increase; p<0.001) and platelet count (HR 0.995 per unit increase; p=0.001) were predictors of mortality. All six predictors were used to build the COVID-19MRS (Area Under the Curve 0.90, 95% CI 0.87 to 0.93), which proved to be highly accurate in stratifying patients at low, intermediate and high risk of in-hospital death (p<0.001).ConclusionsThe COVID-19MRS is a rapid, operator-independent and inexpensive clinical tool that objectively predicts mortality in patients with COVID-19. The score could be helpful from triage to guide earlier assignment of COVID-19 patients to the most appropriate level of care.

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Section: Discussionmentioning

confidence: 99%

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study

et al. 2020

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“…This is compounded by the reduced ability of the cilia lining the upper and lower airway to efficiently work to move foreign particles and mucus up and out of the airways [37]. Structurally, there is an increase in average alveolus size and decrease in alveolus elasticity, and this affects the efficiency of air exchange and susceptibility for alveolar damage during infections [38,39].…”

Section: Lung Agingmentioning

confidence: 99%

The untwining of immunosenescence and aging

Wong

Hwang

et al. 2020

Semin Immunopathol

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From a holistic point of view, aging results from the cumulative erosion of the various systems. Among these, the immune system is interconnected to the rest as immune cells are present in all organs and recirculate through bloodstream. Immunosenescence is the term used to define the remodelling of immune changes during aging. Because immune cells—and particularly lymphocytes—can further differentiate after their maturation in response to pathogen recognition, it is therefore unclear when senescence is induced in these cells. Additionally, it is also unclear which signals triggers senescence in immune cells (i) aging per se, (ii) specific response to pathogens, (iii) underlying conditions, or (iv) inflammaging. In this review, we will cover the current knowledge and concepts linked to immunosenescence and we focus this review on lymphocytes and T cells, which represent the typical model for replicative senescence. With the evidence presented, we propose to disentangle the senescence of immune cells from chronological aging.

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“…Prior studies have established that lung function declined progressively with aging [9,10], while good lung function was thought to benefit a healthier and longer life [11]. Low birthweight, ambient air pollution, obesity, and asthma were confirmed as determinants of lung function impairment among never-smokers [12].…”

Section: Introductionmentioning

confidence: 92%

Association of lung function with functional limitation in older adults: A cross-sectional study

et al. 2021

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Introduction Impaired lung function is independently associated with higher rates of disability, however, few studies have examined the association between lung function and functional limitation. This study aimed to assess this association and dose-response relationship in older adults. Methods Data from the National Health and Nutrition Examination Survey (2007–2012) was used as a cross-sectional study. Lung function was determined by Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Functional limitation in older adults was identified by six self-reported questions on physical function. 3070 adults aged 60 and over were enrolled in our study. Logistic regression models and restricted cubic spline models were applied to examine the association between lung function and the risk of functional limitation. Results FEV1 and FVC were inversely associated with the risk of functional limitation. In the full adjusted model, compared with the lowest tertile of FEV1, the odds ratios (95% confidence intervals) of functional limitation for tertile 2 and tertile 3 were 0.5422 (0.3848–0.7639) and 0.4403 (0.2685–0.7220), and the odds ratios (95% confidence intervals) of functional limitation for tertile 2 and tertile 3 of FVC were 0.5243 (0.3503–0.7848) and 0.3726 (0.2072–0.6698). Furthermore, an inverse association persisted after stratified analysis by gender and sensitivity analysis. Dose-response analyses showed that the odds of functional limitation declined with increase in FEV1 and FVC in a nonlinear manner. Conclusions Lung function was inversely associated with functional limitation among older adults.

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The Aging Lung

Cited by 59 publications

References 120 publications

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study

Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study

The untwining of immunosenescence and aging

Association of lung function with functional limitation in older adults: A cross-sectional study

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