Two vicious circles associated with the aging of the immune system in the development of severe forms of COVID-19

Frontiers in Aging

Aging

Ana Milinkovic¹  Miodrag Vrbic² 

[1] Chelsea and Westminster Foundation Trust and Imperial College London, London, United Kingdom;Clinic for Infectious Diseases—UCC Nis, Nis, Serbia;

关键词: COVID-19;    MODS;    senescence of adoptive immunity;    sepsis;    pathogenesis;   

DOI  :  10.3389/fragi.2023.1260053

 received in 2023-07-21, accepted in 2023-09-04,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background: The immune-inflammatory response is the basis of the pathophysiology of SARS-Cov-2 infection. In severe cases of COVID-19 uncontrolled systemic inflammatory response causes multiorgan dysfunction (MODS), as the most common immediate cause of death. Unfavorable outcome of the COVID-19 most often occurs in elderly patients. The aim of the study was to establish parameters with prognostic significance in severe cases of COVID-19 according to life years, laboratory markers of sepsis and MODS, as well as the number of peripheral CD4+ and CD8+T lymphocytes in 20 consecutively selected critically ill patients.Results: Eleven subjects were male, 9 female, mean age 73.45 ± 11.59, among which the oldest patient was 94 and the youngest 43 years. All the patients met the sepsis and MODS criteria. Increased age and low CD4+ and CD8+T cell counts were identified as independent predictors of death. Only the two youngest patients (43 and 50 years old) survived 28 days, and they are the only ones with a CD4 lymphocyte count above 500 cells/mm3.Conclusion: Senescence of the immune system is mostly characterized by reduced regenerative capacity of adaptive immunity with diminished ability to respond to new antigens and a manifested proinflammatory phenotype. Additional reduction of protective capacity by further deterioration of T cell quantity and quality due to sepsis itself and mutual interaction of senescent T cells and vascular endothelial cells in the induction of cytokine storm represent two complementary vicious cycles in the development of sepsis-related multiorgan dysfunction.

【 授权许可】

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Copyright © 2023 Vrbic and Milinkovic.