Immunosenescence and the Susceptibility of the Elderly to Coronavirus Disease 2019 (COVID-19)

Widya Wasityastuti, Andika Dhamarjati, Siswanto Siswanto

Abstract


A new disease caused by a newly-found coronavirus, known as Coronavirus Disease 2019 (COVID-19), has been declared as a pandemic by World Health Organization (WHO). This new disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak started in late December of 2019 and it did not take a long time until it spread to more than 200 countries in the world with over 4 million confirmed cases to date. The number keeps skyrocketing as day passes, followed by the increasing number of fatalities. Among all of the infected patients, elderly is one of the vulnerable populations. Studies reported that the risk of infection is doubled in older people. This infection-susceptible characteristic may be due to the weak immune system, therefore they lack the capabilities to fight the infection. The deterioration of immune system in elderly is known as immunosenescence. The aim of this literature review is to understand the effect of immunosenescence in the immunopathogenesis and susceptibility of elderly who are exposed to COVID-19 infection. Published articles regarding the relationship between immunosenescence and COVID-19 will be conveyed as clinical interest, with the hope that they will be beneficial to guide the standard treatment and as an educative protocol for the patients.

Keywords


COVID-19; immunosenescence; immune system; elderly

References


Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020; 579(7798): 265-9.

World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report. [cited at May 16, 2020]. Available at URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Handayani D, Hadi DR, Isbaniah F, Burhan E, Agustin H. Corona Virus Disease. J Respir Indo. 2020.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.

Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. J Am Med Assoc. 2020; 323(18):1775-1776.

Kluge HHP. Statement – Older people are at highest risk from COVID-19, but all must act to prevent community spread. World Health Organization. [cited at May 17, 2020]. Available from URL: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/statements/statement-older-people-are-at-highest-risk-from-covid-19,-but-all-must-act-to-prevent-community-spread

Setiati S, Laksmi PW, Aryana IS, Istanti R, Ardian LJ, Chotimah SC. Frailty state among Indonesian elderly: prevalence, associated factors, and frailty state transition. BMC Geriatr. 2019;19(182).

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–74.

Zhou P, Yang X-L, Wang X-G, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270–3.

Patel AB, Verma A. COVID-19 and Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers. J Am Med Assoc. 2020; 323(18):1769-1770.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-20.

Tay MZ, Poh CM, Rénia L, Macary PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020.

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunologic features in severe and moderate forms of Coronavirus Disease 2019. J Clin Invest. 2020; 1;130(5):2620-2629 2020.

Jose RJ, Manuel A. COVID-19 cytokine storm: the interplay between inflammation and coagulation. Lancet Respir Med. 2020.

Abbas AK, Lichtman AH, Pillai S. Basic immunology: functions and disorders of the immune system. 7th ed. Philadelphia: Elsevier; 2016.

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020; 82:727-33.

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020;10:102–8.

Prompetchara E, Ketloy C, Palaga T. Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pac J Allergy. 2020;38:1–9.

Channappanavar R, Fehr AR, Vijay R, Mack M, Zhao J, Meyerholz DK, et al. Dysregulated Type I Interferon and Inflammatory Monocyte-Macrophage Responses Cause Lethal Pneumonia in SARS-CoV-Infected Mice. Cell Host Microbe. 2016;19(2):181‐193.

Teijaro JR. Type I interferons in viral control and immune regulation. Curr Opin Virol. 2016;16:31–40.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. J Am Med Assoc. 2020;323(11):1061–1069.

Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. 2020;27:1451–4.

Wu F, Wang A, Liu M, Wang Q, Chen J, Xia S, et al. Neutralizing Antibody Responses to SARS-CoV-2 in a COVID-19 Recovered Patient Cohort and Their Implications. medRxiv. 2020.

Xiao AT, Gao C, Zhang S. Profile of specific antibodies to SARS-CoV-2: The first report. J Infection. 2020.

Li G, Chen X, Xu A. Profile of Specific Antibodies to the SARS-Associated Coronavirus. N Engl J Med. 2003;349:508–9.

Mo HY, Zeng GQ, Ren XL, et al. Longitudinal profile of antibodies against SARS-coronavirus in SARS patients and their clinical significance. Respirology. 2006;11:49–53.

Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. PNAS. 2020;117(17):9490-9496.

Vanblargan LA, Goo L, Pierson TC. Deconstructing the Antiviral Neutralizing-Antibody Response: Implications for Vaccine Development and Immunity. Microbiol Mol Biol R. 2016;80:989–1010.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420–2.

Fan Y-Y, Huang Z-T, Li L, Wu M-H, Yu T, Koup RA, et al. Characterization of SARS-CoV-specific memory T cells from recovered individuals 4 years after infection. Arch Virol. 2009;154:1093–9.

Ganji A, Farahani I, Khansarinejad B, Ghazavi A, Mosayebi G. Increased expression of CD8 marker on T-cells in COVID-19 patients. Blood Cell Mol Dis. 2020;83:102437.

Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020.

Halter JB, Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S. 2016. Hazzard’s Geriatric Medicine and Gerontology 10th. McGraww Hill: Toronto.

Murray MA, Chotirmall SH. The Impact of Immunosenescence on Pulmonary Disease. Mediat Inflamm. 2015;2015:1–10.

Pang WW, Schrier SL, Weissman IL. Age-associated changes in human hematopoietic stem cells. Semin Hematol. 2017;54:39–42.

Latchney SE, Calvi LM. The aging hematopoietic stem cell niche: Phenotypic and functional changes and mechanisms that contribute to hematopoietic aging. Semin Hematol. 2017;54:25–32.

Nilsson AR, Nilsson AR, Soneji S, Adolfsson S, Bryder D, Pronk C. Human and murine hematopoietic stem cell aging is associated with functional impairments and intrinsic megakaryocytic/erythroid bias. Exp Hematol. 2016;44.

Mesa R, Alvarez-Larran A, Harrison C, Kiladjian J-J, Rambaldi A, Tefferi A, et al. COVID-19 and Myeloproliferative Neoplasms: Frequently Asked Questions. American Society of Hematology. [cited May 15, 2020]. Available from URL: https://www.hematology.org/covid-19/covid-19-and-myeloproliferative-neoplasms

Wong CK, Smith CA, Sakamoto K, Kaminski N, Koff JL, Goldstein DR. Aging Impairs Alveolar Macrophage Phagocytosis and Increases Influenza-Induced Mortality in Mice. J Immunol. 2017;199:1060–8.

Gupta S. Role of dendritic cells in innate and adaptive immune response in human aging. Exp Gerontol. 2014;54:47–52.

Zacca ER, Crespo MI, Acland RP, Roselli E, Núñez NG, Maccioni M, et al. Aging Impairs the Ability of Conventional Dendritic Cells to Cross-Prime CD8 T Cells upon Stimulation with a TLR7 Ligand. PloS One. 2015;10(10):e0140672.

McBride JA, Striker R. Imbalance in the game of T cells: What can the CD4/CD8 T-cell ratio tell us about HIV and health? PLoS Pathog. 2017;13.

Lanzer KG, Johnson LL, Woodland DL, Blackman MA. Impact of ageing on the response and repertoire of influenza virus-specific CD4 T cells. Immun Ageing. 2014;11:9.

Gitlin AD, Nussenzweig MC. Immunology: Fifty years of B lymphocytes. Nature. 2015;517:139–41.

Pritz T, Lair J, Ban M, Keller M, Weinberger B, Krismer M, et al. Plasma cell numbers decrease in bone marrow of old patients. Eur J Immunol. 2014;45:738–46.

Fuentes E, Fuentes M, Alarcón M, Palomo I. Immune System Dysfunction in the Elderly. An Acad Bras Ciênc. 2017;89:285–99.

Crooke SN, Ovsyannikova IG, Poland GA, Kennedy RB. Immunosenescence and human vaccine immune responses. Immun Ageing. 2019;16(25).

Shahid Z, Kalayanamitra R, Mcclafferty B, Kepko D, Ramgobin D, Patel R, et al. COVID ‐19 and Older Adults: What We Know. J Am Geriatr Soc. 2020;68(5):926-929.

Alam I, Almajwal AM, Alam W, Alam I, Ullah N, Abulmeaaty M, et al. The immune-nutrition interplay in aging – facts and controversies. NHA. 2019;5:73–95.

Francesco VD, Pellizzari L, Corrà L, Fontana G. The anorexia of aging: impact on health and quality of life. Geriatric Care 2018;4.




DOI: https://doi.org/10.36497/jri.v40i3.115

Refbacks

  • There are currently no refbacks.





Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org


An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License

Statcounter