ABSTRACT
As humans age, their immune system undergoes modifications, including a low-grade inflammatory status called inflammaging. These changes are associated with a loss of physical and immune resilience, amplifying the risk of being malnourished and frail. Under the COVID-19 scenario, inflammaging increases the susceptibility to poor prognostics. We aimed to bring the current concepts of inflammaging and its relationship with frailty and COVID-19 prognostic; highlight the importance of evaluating the nutritional risk together with frailty aiming to monitor older adults in COVID-19 scenario; explore some compounds with potential to modulate inflammaging in perspective to manage the COVID-19 infection. Substances such as probiotics and senolytics can help reduce the high inflammatory status. Also, the periodic evaluation of nutrition risk and frailty will allow interventions, assuring the appropriate care.
Subject(s)
COVID-19 , Frailty , Aged , Frail Elderly , Frailty/prevention & control , Humans , Nutritional Status , SARS-CoV-2 , SenotherapeuticsABSTRACT
Risk factors that determine the severity of Covid-19 have not been fully elucidated. The aim of this study was to evaluate the role of coronary artery calcification (CAC) as a risk factor for death or mechanical ventilation (MV) of patients without known heart disease infected with Covid-19. We analyzed 283 consecutive in-patients with acute respiratory symptoms with chest computed tomography (chest-CT), without previous heart disease, and criteria for Covid-19 (RT-PCR positive and/or typical clinical and chest-CT findings). CAC was classified by the number of coronary segments affected as absent (0), mild (1-3), and severe calcification (more than 3). The association between CAC, CAC severity, and death or MV due to severe respiratory failure was assessed by logistic regression. The mean age was 58.7±15.7 years and 54.1% were men. Patients with CAC were older, more likely to have hypertension, and less likely to be obese. CAC was present in 75 patients (26.5%), of which 42 had a mild calcification and 33 had severe calcification, and was associated with death (OR=2.35, 95%CI: 1.01-5.48) or MV (OR=2.72, 95%CI: 1.20-6.20) adjusted for multiple confounders, with significant and increased odds ratio for the severe form of CAC (death: OR=3.70, 95%CI: 1.20-11.42; MV: OR=3.30, 95%CI: 1.09-9.95). We concluded that CAC was an independent risk factor for death or MV in Covid-19 patients without previous heart disease, particularly for those with severe calcification. CAC can be easily visualized on common chest-CT, widely used in evaluation of moderate to severe Covid-19.
Subject(s)
COVID-19 , Coronary Artery Disease , Vascular Calcification , Adult , Aged , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Humans , Male , Middle Aged , Odds Ratio , Risk Factors , SARS-CoV-2 , Vascular Calcification/complications , Vascular Calcification/diagnostic imagingABSTRACT
The authors apologize for a typing error that occurred in the September 2020 article that changes the meaning of a sentence. Correction: Page 921, right column, 2nd paragraph, line 8, change «match» to «watch» so it reads, «Primary care providers should watch for frailty development due to physical inactivity during the COVID-19 pandemic (47).» In addition, the author listed as “C. Won Won” wishes to be known as “C.W. Won.” © 2020, The Journal of Nutrition, Health & Aging.