Polymorbidity in seniors hospitalized for COVID-19.

BACKGROUND: The health of seniors is usually characterized by polymorbidity. With regard to quoad vitam prognosis, COVID-19 is extremely risky for seniors. The data on polymorbidity in seniors with COVID-19 are scarce. OBJECTIVE: To investigate comorbidity in seniors diagnosed with COVID-19 and requiring hospitalization. METHODS: In a retrospective observational study, we analyzed patients aged 65 years or older and hospitalized primarily for COVID-19 from November 1, 2020, to April 30, 2021 (n=155; mean age 82 years). We monitored the presence of 48 diseases accompanying COVID-19. RESULTS: The mean (minimal - maximal) number of acute, chronic and all comorbidities were 1.8 (0‒5), 11.3 (2‒20) and 13.1 (4‒22), respectively. Excessive comorbidity (>10 diseases) was present in 72.3 %. Comorbid arterial hypertension was diagnosed in 86 %, chronic kidney disease in 86 %, hepatopathy in 82 %, coronary artery disease in 79 %, dehydration in 46 %, and urinary infections in 30 %. Twenty-six chronic comorbidities had a prevalence of >10 %. Residents of social care facilities (SCF) had significantly higher polymorbidity than home-living seniors (on average by 3.5 more diseases, their OR for excessive polymorbidity was 11.8). The prevalence of overall, chronic and excess polymorbidity increased up to the age of 84 years. Nine out of ten seniors aged 80 years or older had 11 or more comorbidities. CONCLUSION: The burden of accompanying diseases in seniors with severe COVID-19 is very high. Seniors living in SCF are particularly at risk (Tab. 5, Fig. 8, Ref. 58).

On the Origin of Neutrophil Extracellular Traps in COVID-19.

Despite ongoing vaccination COVID-19 is a global healthcare problem because of the lack of an effective targeted therapy. In severe COVID-19 manifesting as acute respiratory distress syndrome, uncontrolled innate immune system activation results in cytokine deregulation, damage-associated molecular patterns release upon tissue damage and high occurrence of thrombotic events. These pathomechanisms are linked to neutrophil function and dysfunction, particularly increased formation of neutrophil extracellular traps (NETs). While the association of NETs and severity of COVID-19 has been shown and proved, the causes of NETs formation are unclear. The aim of this review is to summarize potential inducers of NETs formation in severe COVID-19 and to discuss potential treatment options targeting NETs formation of removal.