A distinct association of inflammatory molecules with outcomes of COVID-19 in younger versus older adults

Authors

Junghee J. Shin, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Sangchoon Jeon, Yale University School of Nursing, West Haven, CT 06516, USA.
Serhan Unlu, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Jennefer Par-Young, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Min Sun Shin, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
John K. Kuster, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Yuliya Afinogenova, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Yumi Kang, Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT 06610, United States of America.
Michael Simonov, Clinical and Translational Research Accelerator (CTRA), Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Gregory Buller, Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT 06610, United States of America.Follow
Richard Bucala, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
Insoo Kang, Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA. Electronic address: Insoo.kang@yale.edu.

Document Type

Article

Publication Title

Clinical immunology (Orlando, Fla.)

Abstract

Aging can alter immunity affecting host defense. COVID-19 has the most devastating clinical outcomes in older adults, raising the implication of immune aging in determining its severity and mortality. We investigated biological predictors for clinical outcomes in a dataset of 13,642 ambulatory and hospitalized adult COVID-19 patients, including younger (age < 65, n = 566) and older (age ≥ 65, n = 717) subjects, with in-depth analyses of inflammatory molecules, cytokines and comorbidities. Disease severity and mortality in younger and older adults were associated with discrete immune mechanisms, including predominant T cell activation in younger adults, as measured by increased soluble IL-2 receptor alpha, and increased IL-10 in older adults although both groups also had shared inflammatory processes, including acute phase reactants, contributing to clinical outcomes. These observations suggest that progression to severe disease and death in COVID-19 may proceed by different immunologic mechanisms in younger versus older subjects and introduce the possibility of age-based immune directed therapies.

First Page

108857

DOI

10.1016/j.clim.2021.108857

Publication Date

11-1-2021

Recommended Citation

Shin, Junghee J.; Jeon, Sangchoon; Unlu, Serhan; Par-Young, Jennefer; Shin, Min Sun; Kuster, John K.; Afinogenova, Yuliya; Kang, Yumi; Simonov, Michael; Buller, Gregory; Bucala, Richard; and Kang, Insoo, "A distinct association of inflammatory molecules with outcomes of COVID-19 in younger versus older adults" (2021). Internal Medicine. 12.
https://scholar.bridgeporthospital.org/internal_medicine/12

Identifier

34560283 (pubmed); PMC8455237 (pmc); 10.1016/j.clim.2021.108857 (doi); S1521-6616(21)00194-7 (pii)