Uremia-Associated Immunological Aging and Severity of COVID-19 Infection

Frontiers in Medicine

article

Michiel G. H. Betjes¹ 

[1] Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Centre

关键词: uremia;    chronic kidney disease;    thymus;    adaptive immunity;    lymphopenia;    immunological aging;    COVID-19;   

DOI  :  10.3389/fmed.2021.675573

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

One year after the start of the COVID-19 pandemic it has become clear that some groups of individuals are at particular high risk of a complicated course of infection resulting in high morbidity and mortality. Two specific risk factors are most prominent, old age and the presence of co-morbidity. Recent studies have shown that patients with compromised renal function, especially those treated with renal replacement therapy or having received a kidney transplant are at a much higher risk for severe COVID infection and increased mortality. This may be in part due to the increased prevalence of co-morbid conditions in these patients but specific alterations in their immune system, reflecting premature immunological aging, may be equally important. In this review the different aspects, in particular thymus function and memory T cell expansion, of uremia-associated immunological aging are reviewed with respect to COVID 19 infection. In essence, the decreased generation of naïve T cells may be instrumental in suboptimal anti-viral immune responses while the relatively uncontrolled expansion of effector T cells may facilitate the feared phase of the COVID-19 infection with excessive and live-threatening inflammation of the lung parenchyma.

【 授权许可】

CC BY