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1.
Cells ; 10(12)2021 11 30.
Article in English | MEDLINE | ID: covidwho-1613627

ABSTRACT

The COVID-19 pandemic drastically highlighted the vulnerability of the elderly population towards viral and other infectious threats, illustrating that aging is accompanied by dysregulated immune responses currently summarized in terms like inflammaging and immunoparalysis. To gain a better understanding on the underlying mechanisms of the age-associated risk of adverse outcome in individuals experiencing a SARS-CoV-2 infection, we analyzed the impact of age on circulating monocyte phenotypes, activation markers and inflammatory cytokines including interleukin 6 (IL-6), IL-8 and tumor necrosis factor (TNF) in the context of COVID-19 disease progression and outcome in 110 patients. Our data indicate no age-associated differences in peripheral monocyte counts or subset composition. However, age and outcome are associated with differences in monocyte activation status. Moreover, a distinct cytokine pattern of IL-6, IL-8 and TNF in elderly survivors versus non-survivors, which consolidates over the time of hospitalization, suggests that older patients with adverse outcomes experience an inappropriate immune response, reminiscent of an inflammaging driven immunoparalysis. Our study underscores the value, necessity and importance of longitudinal monitoring in elderly COVID-19 patients, as dynamic changes after symptom onset can be observed, which allow for a differentiated insight into confounding factors that impact the complex pathogenesis following an infection with SARS-CoV-2.


Subject(s)
Aging/pathology , COVID-19/blood , COVID-19/pathology , Cytokines/blood , Monocytes/pathology , Acute Disease , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Biomarkers/metabolism , Humans , Longitudinal Studies , Middle Aged , Neutrophils/metabolism , Prospective Studies , SARS-CoV-2 , Young Adult
2.
Cells ; 10(12)2021 12 11.
Article in English | MEDLINE | ID: covidwho-1598389

ABSTRACT

Both in utero exposure to maternal immune activation and cannabis use during adolescence have been associated with increased risk for the development of schizophrenia; however, whether these exposures exert synergistic effects on brain function is not known. In the present study, mild maternal immune activation (MIA) was elicited in mice with prenatal exposure to polyinosinic-polycytidylic acid (poly(I:C)), and ∆9-tetrahydrocannabinol (THC) was provided throughout adolescence in cereal (3 mg/kg/day for 5 days). Neither THC nor MIA pretreatments altered activity in assays used to characterize hyperdopaminergic states in adulthood: amphetamine hyperlocomotion and prepulse inhibition of the acoustic startle reflex. Adolescent THC treatment elicited deficits in spatial memory and enhanced spatial reversal learning in adult female mice in the Morris water maze, while exposure to MIA elicited female-specific deficits in fear extinction learning in adulthood. There were no effects in these assays in adult males, nor were there interactions between THC and MIA in adult females. While doses of poly(I:C) and THC were sufficient to elicit behavioral effects, particularly relating to cognitive performance in females, there was no evidence that adolescent THC exposure synergized with the risk imposed by MIA to worsen behavioral outcomes in adult mice of either sex.


Subject(s)
Aging/physiology , Behavior, Animal/drug effects , Dronabinol/pharmacology , Prenatal Exposure Delayed Effects/immunology , Amphetamine , Animals , Conditioning, Classical , Extinction, Psychological/drug effects , Fear/drug effects , Female , Locomotion/drug effects , Male , Maze Learning/physiology , Mice, Inbred C57BL , Pregnancy , Prepulse Inhibition/drug effects , Rats, Sprague-Dawley , Reflex, Startle/drug effects , Swimming
3.
Ann Agric Environ Med ; 28(4): 551-557, 2021 Dec 29.
Article in English | MEDLINE | ID: covidwho-1595556

ABSTRACT

INTRODUCTION AND OBJECTIVE: Poland is engaged in the implementation of activation programmes for seniors at governmental as well as non-governmental levels. Among these programmes may be mentioned, 'Active+', 'Senior+', 'Care 75+', and 'Senior Caritas'. The COVID-19 pandemic highlighted the need for the inclusion of seniors into social life, and concern about their health. An important challenge for social and ageing policy is the provision of proper standards of care and health protection, especially during an increased sanitary regime. The aim of the study was analysis of the ageing policy strategy and the quality of life of seniors before and during the COVID-19 pandemic. REVIEW METHODS: The study was conducted by the method of analysis of data in the area of national initiatives concerning activation programmes for seniors implemented during 2020-2021. The starting point was the well-established definition of the quality of life by the WHO. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: The analysis performed showed a multitude of factors determining the needs of seniors at the time of the pandemic, which often differed from those observed earlier. The latest studies of the quality of life of the elderly in Poland demonstrated that nearly 60% of respondents assessed their psychological condition as worse than before the pandemic. Another problem was the issue of physical activity, which was limited by more than 62% of seniors, and difficulties with access to health care system services. SUMMARY: It seems necessary to implement forms of assistance which could be adjusted to the changing epidemiological conditions, in order to improve the quality of life of persons who, in the near future, will constitute a considerable percentage of Polish society.


Subject(s)
COVID-19 , Pandemics , Aged , Aging , Humans , Poland/epidemiology , Policy , Quality of Life , SARS-CoV-2
4.
Sci Rep ; 11(1): 23993, 2021 12 14.
Article in English | MEDLINE | ID: covidwho-1585801

ABSTRACT

Previous work indicates that SARS-CoV-2 virus entry proteins angiotensin-converting enzyme 2 (ACE-2) and the cell surface transmembrane protease serine 2 (TMPRSS-2) are regulated by sex hormones. However, clinical studies addressing this association have yielded conflicting results. We sought to analyze the impact of sex hormones, age, and cardiovascular disease on ACE-2 and TMPRSS-2 expression in different mouse models. ACE-2 and TMPRSS-2 expression was analyzed by immunostaining in a variety of tissues obtained from FVB/N mice undergoing either gonadectomy or sham-surgery and being subjected to ischemia-reperfusion injury or transverse aortic constriction surgery. In lung tissues sex did not have a significant impact on the expression of ACE-2 and TMPRSS-2. On the contrary, following myocardial injury, female sex was associated to a lower expression of ACE-2 at the level of the kidney tubules. In addition, after myocardial injury, a significant correlation between younger age and higher expression of both ACE-2 and TMPRSS-2 was observed for lung alveoli and bronchioli, kidney tubules, and liver sinusoids. Our experimental data indicate that gonadal hormones and biological sex do not alter ACE-2 and TMPRSS-2 expression in the respiratory tract in mice, independent of disease state. Thus, sex differences in ACE-2 and TMPRSS-2 protein expression observed in mice may not explain the higher disease burden of COVID-19 among men.


Subject(s)
Aging/metabolism , Angiotensin-Converting Enzyme 2/metabolism , Cardiomyopathies/metabolism , Castration/adverse effects , Serine Endopeptidases/metabolism , Animals , Bronchioles/metabolism , Disease Models, Animal , Female , Gene Expression Regulation , Kidney Tubules/metabolism , Liver/metabolism , Male , Mice , Pulmonary Alveoli/metabolism , Virus Internalization
5.
BMC Health Serv Res ; 21(1): 1355, 2021 Dec 19.
Article in English | MEDLINE | ID: covidwho-1582072

ABSTRACT

BACKGROUND: Chronic conditions are common and require ongoing continuous management and preventive measures. The COVID-19 pandemic may have affected the management of chronic conditions by delaying care. We sought to understand the impact of personal characteristics (i.e., age) and healthcare factors (i.e., access to a provider) on healthcare access in a sample of Americans 50 years of age or older during COVID-19. METHOD: Participants completed an online survey at the start of the COVID-19 pandemic - the Aging in the Time of COVID Survey. Questions focused on health status, health care access, COVID-19 fear, and social connectedness. Participants were recruited through social media advertisements, list serves, and snowball sampling. Data collection started in early April 2020 and concluded in late May 2020. Logistic regression models examined the results of two key access points: healthcare provider/doctor (n = 481) and medication (n = 765), with 56 and 93% of participants reporting access to a provider and medications, respectively. RESULTS: Individuals with an established primary care provider were much more likely to obtain access to a healthcare provider, OR = 3.81 (95% CI: 1.69, 8.77), and to receive medication, OR = 4.48 (95% CI: 1.61, 11.48), during the time of COVID-19. In addition, access to medication was (a) higher for those who were older, OR = 1.05 (95% CI: 1.01, 1.09), had a higher income (greater than 100 k compared to less than 50 k, OR = 3.04 (95% CI: 1.11, 8.98), and (b) lower for those having caregiving responsibilities, OR = 0.41 (95% CI: 0.21, 0.78), or greater social isolation, OR = 0.93 (95% CI: 0.87, 0.98). CONCLUSIONS: Although most participants had access to medication, just over half had access to a healthcare provider when needed. Notably, health-seeking behaviors for individuals who do not have an established primary care providers as well as those who provide unpaid care, are socially isolated, and younger may require more proactive approaches to care monitoring, management, and maintenance.


Subject(s)
COVID-19 , Aging , Health Services Accessibility , Humans , Pandemics , SARS-CoV-2 , Self Report
6.
PLoS One ; 16(3): e0247993, 2021.
Article in English | MEDLINE | ID: covidwho-1574098

ABSTRACT

Population ageing requires society to adjust by ensuring additional types of services and assistance for elderly people. These may be provided by either organized services and sources of informal social support. The latter are especially important since a lack of social support is associated with a lower level of psychological and physical well-being. During the Covid-19 pandemic, social support for the elderly has proven to be even more crucial, also due to physical distancing. Therefore, this study aims to identify and describe the various types of personal social support networks available to the elderly population during the pandemic. To this end, a survey of Slovenians older than 64 years was conducted from April 25 to May 4, 2020 on a probability web-panel-based sample (n = 605). The ego networks were clustered by a hierarchical clustering approach for symbolic data. Clustering was performed for different types of social support (socializing, instrumental support, emotional support) and different characteristics of the social support networks (i.e., type of relationship, number of contacts, geographical distance). The results show that most of the elderly population in Slovenia has a satisfactory social support network, while the share of those without any (accessible) source of social support is significant. The results are particularly valuable for sustainable care policy planning, crisis intervention planning as well as any future waves of the coronavirus.


Subject(s)
COVID-19/psychology , Psychosocial Support Systems , Social Support , Aged , Aged, 80 and over , Aging , COVID-19/epidemiology , Coronavirus Infections/epidemiology , Female , Humans , Male , Pandemics/statistics & numerical data , SARS-CoV-2/pathogenicity , Slovenia/epidemiology , Surveys and Questionnaires
7.
Nat Rev Immunol ; 20(7): 406-407, 2020 07.
Article in English | MEDLINE | ID: covidwho-1550296
8.
Cells ; 10(12)2021 11 30.
Article in English | MEDLINE | ID: covidwho-1542429

ABSTRACT

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a global pandemic associated with substantial morbidity and mortality worldwide, with particular risk for severe disease and mortality in the elderly population. SARS-CoV-2 infection is driven by a pathological hyperinflammatory response which results in a dysregulated immune response. Current advancements in aging research indicates that aging pathways have fundamental roles in dictating healthspan in addition to lifespan. Our review discusses the aging immune system and highlights that senescence and aging together, play a central role in COVID-19 pathogenesis. In our review, we primarily focus on the immune system response to SARS-CoV-2 infection, the interconnection between severe COVID-19, immunosenescence, aging, vaccination, and the emerging problem of Long-COVID. We hope to highlight the importance of identifying specific senescent endotypes (or "sendotypes"), which can used as determinants of COVID-19 severity and mortality. Indeed, identified sendotypes could be therapeutically exploited for therapeutic intervention. We highlight that senolytics, which eliminate senescent cells, can target aging-associated pathways and therefore are proving attractive as potential therapeutic options to alleviate symptoms, prevent severe infection, and reduce mortality burden in COVID-19 and thus ultimately enhance healthspan.


Subject(s)
Aging/pathology , COVID-19/pathology , SARS-CoV-2/physiology , Animals , Biomarkers/metabolism , Cellular Senescence , Humans
9.
Epidemiol Infect ; 149: e230, 2021 10 22.
Article in English | MEDLINE | ID: covidwho-1537261

ABSTRACT

We conducted a retrospective observational study in patients with laboratory-confirmed coronavirus disease (COVID-19) who received medical care in 688 COVID-19 ambulatory units and hospitals in Mexico City between 24 February 2020 and 24 December 2020, to study if the elderly seek medical care later than younger patients and their severity of symptoms at initial medical evaluation. Patients were categorised into eight groups (<20, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79 and ≥80 years). Symptoms at initial evaluation were classified according to a previously validated classification into respiratory and non-respiratory symptoms. Comparisons between time from symptom onset to medical care for every age category were performed through variance analyses. Logistic regression models were applied to determine the risk of presenting symptoms of severity according to age, and mortality risk according to delays in medical care. In total, 286 020 patients were included (mean age: 42.8, s.d.: 16.8 years; 50.4% were women). Mean time from symptom onset to medical care was 4.04 (s.d.: 3.6) days and increased with older age categories (P < 0.0001). Mortality risk increased by 6.4% for each day of delay in medical care from symptom onset. The risk of presenting with the symptoms of severity was greater with increasing age categories. In conclusion, COVID-19 patients with increasing ages tend to seek medical care later, with higher rates of symptoms of severity at initial presentation in both ambulatory units and hospitals.


Subject(s)
Aging , COVID-19/epidemiology , Time-to-Treatment/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Mexico/epidemiology , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Young Adult
10.
Home Healthc Now ; 39(6): 301, 2021.
Article in English | MEDLINE | ID: covidwho-1532616
12.
Eur Rev Med Pharmacol Sci ; 25(21): 6719-6730, 2021 11.
Article in English | MEDLINE | ID: covidwho-1524860

ABSTRACT

OBJECTIVE: COVID-19 vaccines have developed quickly, and vaccination programs have started in most countries to fight the pandemic. The aging population is vulnerable to different diseases, also including the COVID-19. A high death rate of COVID-19 was noted from the vulnerable aging population. A present scenario regarding COVID-19 vaccines and vaccination program foraging adults had been discussed. MATERIALS AND METHODS: This paper reviews the current status and future projections till 2050 of the aging population worldwide. It also discusses the immunosenescence and inflammaging issues facing elderly adults and how it affects the vaccinations such as influenza, pneumococcal, and herpes zoster. RESULTS: This paper recommends clinical trials for all approved COVID-19 vaccines targeting the elderly adult population and to project a plan to develop a next-generation COVID-19 vaccine. CONCLUSIONS: The review has mapped the COVID-19 vaccination status from the developed and developing countries for the elderly population. Finally, strategies to vaccinate all elderly adults globally against COVID-19 to enhance longevity has been suggested.


Subject(s)
Aging , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/immunology , Humans , Immunization Programs , Immunosenescence , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Treatment Outcome
13.
Healthc Q ; 24(3): 72-75, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1524622

ABSTRACT

Much is already written on how the COVID-19 pandemic ravaged Canada's frail, elderly population - the impact of the global pandemic turned the decades-long challenges within our nation's long-term care sector into daily news coverage. While no commission or report can ever begin to relieve the pain and suffering of individuals who lived through the pandemic, healthcare leaders owe it to all to respond to the urgent call for action to re-envision elder care for the future. The time to act is now. Our leaders need to collaborate and connect with our seniors to take quick action on their recommendations. Our leaders need to be nimble and creative; they need to work together across the system to rethink how aging seniors can be supported and change the system, its funding models and, ultimately, how we value and care for our aging population now and into the future.


Subject(s)
COVID-19 , Pandemics , Aged , Aging , Canada , Humans , SARS-CoV-2
14.
Arch Gerontol Geriatr ; 98: 104522, 2022.
Article in English | MEDLINE | ID: covidwho-1525683

ABSTRACT

BACKGROUND: Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. METHODS: AGNES cohort data were collected in 2017-2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, composite and sub-scores of active aging were computed. Neighborhood mobility was assessed as frequency of moving in or beyond own neighborhood (limited, regular, daily=reference). Associations were studied using Generalized Linear Models (cross-sectionally, n = 1007) and General Estimating Equations (prospectively, n = 774). RESULTS: Participants with limited baseline neighborhood mobility had lower active aging scores than those with daily mobility, but the decline over time was similar. Some item scores on opportunity to act and extent of doing, e.g. for making one's day more interesting and advancing matters of faith or worldview, were better retained amid COVID-19 by those with limited mobility, attenuating group differences. CONCLUSIONS: Active aging scores were somewhat compromised in individuals with limited neighborhood mobility, but opportunities for and engagement in several activities seemed to be better retained amid COVID-19 than for those with daily mobility. Thus, active aging may be possible despite mobility restriction.


Subject(s)
COVID-19 , Aging , Cross-Sectional Studies , Humans , Mobility Limitation , Residence Characteristics , SARS-CoV-2
15.
Acta Med Port ; 34(11): 761-766, 2021 Nov 02.
Article in Portuguese | MEDLINE | ID: covidwho-1524744

ABSTRACT

INTRODUCTION: In March 2020, the World Health Organization declared COVID-19 as a pandemic, and Portugal reported its initial cases. In this study, we aimed to determine the impact of COVID-19 on Portuguese individuals aged over 60 years old. MATERIAL AND METHODS: We performed a cross-sectional study using data from the Survey of Health, Ageing and Retirement in Europe (SHARE 8: COVID-19 Survey). We selected a sample of 1080 noninstitutional Portuguese individuals aged ≥ 60 years. RESULTS: The study sample consisted of 605 (56%) women and 475 (44%) men, with a mean age of 70 ± 9.1 years. In total, 80% of the participants experienced higher levels of anxiety, 73% felt more depressed and 30% experienced additional sleep problems comparedto the period before the pandemic. Interestingly, there were no statistically significant differences between the sexes or the two selected age groups (60 - 74 and over 75 years old) regarding the incidence of these changes. Only 23%, of those that were interviewed maintained their walking routines. In addition, only 8% of the participants continued visiting family members as frequently as before. While 8% of the participants were refused some form of medical treatment, 56% claimed that they experienced healthcare delays. However,only 15% of the participants reported that their health status worsened during the pandemic. DISCUSSION: The pandemic has had a significant impact on Portuguese individuals aged ≥ 60 years; which is in agreement with the findings of previous international studies. It changed the participants' routines and increased their anxiety and depression levels. Despite the deterioration of healthcare services, most participants did not experience worsening of their health status. CONCLUSION: In conclusion, a COVID-19 pandemic had a significant impact on the elderly population, particularly regarding their mental health.


Introdução: Em março de 2020, a COVID-19 foi declarada pandemia pela Organização Mundial da Saúde e Portugal registou os seus primeiros casos. Este estudo visou determinar o impacto da COVID-19 na população portuguesa maior de 60 anos. Material e Métodos: Trata-se de um estudo observacional transversal que analisa várias variáveis de saúde, comportamentais, sociais e económicas. Utilizaram-se dados do projecto Survey of Health, Ageing and Retirement (SHARE 8: COVID-19 Survey), seleccionando uma amostra de 1080 portugueses não institucionalizados e maiores de 60 anos. Resultados: A amostra englobou 605 mulheres (56%) e 475 homens (44%), com idade média de 70 ± 9,1 anos. No total, 80% dos participantes notou aumento da ansiedade, 73% sentiu-se mais deprimido e 30% considerou que o seu sono piorou em relação ao período anterior à pandemia. Não houve diferenças estatisticamente significativas entre os sexos ou as duas faixas etárias analisadas (60 - 74 e ≥ 75 anos) quanto à incidência destas alterações. No respeitante a saídas de casa, apenas 23% dos entrevistados manteve os hábitos de passeio e 8% manteve as visitas a familiares no seu padrão habitual. Relativamente ao acesso a cuidados médicos, a 8% foi negado algum tratamento e 56% queixou-se do adiamento dos cuidados. Apenas 13% referiu um agravamento do seu estado de saúde durante a pandemia. Discussão: Este trabalho mostra que esta pandemia impactou a população portuguesa com mais de 60 anos, o que está em linha com o reportado noutros estudos internacionais. Os hábitos alteraram-se, e a ansiedade e depressão aumentaram. Apesar da deterioração dos cuidados de saúde, a maioria dos participantes não notou agravamento do seu estado de saúde. Conclusão: Em conclusão, a pandemia por COVID-19 teve um impacto significativo na população idosa particularmente no que concerne à sua saúde mental.


Subject(s)
COVID-19 , Aged , Aging , Anxiety , Cross-Sectional Studies , Depression , Female , Humans , Male , Middle Aged , Pandemics , Portugal/epidemiology , Retirement , SARS-CoV-2
16.
Front Public Health ; 9: 655831, 2021.
Article in English | MEDLINE | ID: covidwho-1518561

ABSTRACT

The distribution of the SARS-CoV-2 virus has reached pandemic proportions. While COVID-19 can affect anyone, it is particularly hazardous for those with "co-morbidities." Older age is an especially strong and independent risk factor for hospital and ICU admission, mechanical ventilation and death. Health systems must protect persons at any age while paying particular attention to those with risk factors. However, essential freedoms must be respected and social/psychological needs met for those shielded. The example of the older population in Israel may provide interesting public health lessons. Relatively speaking, Israel is a demographically young country, with only 11.5% of its population 65 years and older as compared with the OECD average of >17%. As well, a lower proportion of older persons is in long-term institutions in Israel than in most other OECD countries. The initiation of a national program to protect older residents of nursing homes and more latterly, a successful vaccine program has resulted in relatively low rates of serious COVID-19 related disease and mortality in Israel. However, the global situation remains unstable and the older population remains at risk. The rollout of efficacious vaccines is in progress but it will probably take years to cover the world's population, especially those living in low- and middle-income countries. Every effort must be made not to leave these poorer countries behind. Marrying the principles of public health (care of the population) with those of geriatric medicine (care of the older individual) offers the best way forward.


Subject(s)
COVID-19 , Aged , Aged, 80 and over , Aging , Humans , Pandemics , Public Health , SARS-CoV-2
17.
Arch Gerontol Geriatr ; 98: 104571, 2022.
Article in English | MEDLINE | ID: covidwho-1509572

ABSTRACT

AIM: To clarify the frequency and correlates of using applications for monitoring and increase of health and well-being among middle-aged and older adults during the COVID-19 pandemic in Germany. METHODS: Data were used from the nationally representative German Ageing Survey (n = 3,174 individuals in the analytical sample; June/July 2020). The frequency of using applications for monitoring and increasing health and well-being (from daily to never) was used as main outcome measure. RESULTS: Among individuals with access to the internet, 76% never used applications for monitoring and increase of health and well-being, whereas about 13% were rare and 11% were frequent users of such applications. Multinomial regressions showed that the likelihood of being a rare user (compared to never users of such applications) was positively associated with being male [RRR: 0.74, 95% CI: 0.59-0.93], the frequency of walks [e.g., several times a week compared to never: RRR: 2.76, 95% CI: 1.15-6.59] and worse self-rated health [RRR: 1.33, 95% CI: 1.11-1.59]. Furthermore, the likelihood of being a frequent user (compared to never users) was positively associated with younger age [RRR: 0.96, 95% CI: 0.94-0.98] and the frequency of walks [daily compared to never: RRR: 2.61, 95% CI: 1.07-6.35]. CONCLUSIONS: Applications for monitoring and increasing health and well-being are used by about one out of four middle-aged and older individuals with access to the internet in Germany during the COVID-19 pandemic. In international comparison, the proportion of users is rather low. Determining the factors associated with such use may help to address non-users.


Subject(s)
COVID-19 , Pandemics , Aged , Aging , Germany/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2
18.
JCI Insight ; 6(21)2021 11 08.
Article in English | MEDLINE | ID: covidwho-1506181

ABSTRACT

COVID-19 is caused by SARS-CoV-2 (SC2) and is more prevalent and severe in elderly and patients with comorbid diseases (CM). Because chitinase 3-like-1 (CHI3L1) is induced during aging and CM, the relationships between CHI3L1 and SC2 were investigated. Here, we demonstrate that CHI3L1 is a potent stimulator of the SC2 receptor angiotensin converting enzyme 2 (ACE2) and viral spike protein priming proteases (SPP), that ACE2 and SPP are induced during aging, and that anti-CHI3L1, kasugamycin, and inhibitors of phosphorylation abrogate these ACE2- and SPP-inductive events. Human studies also demonstrate that the levels of circulating CHI3L1 are increased in the elderly and patients with CM, where they correlate with COVID-19 severity. These studies demonstrate that CHI3L1 is a potent stimulator of ACE2 and SPP, that this induction is a major mechanism contributing to the effects of aging during SC2 infection, and that CHI3L1 co-opts the CHI3L1 axis to augment SC2 infection. CHI3L1 plays a critical role in the pathogenesis of and is an attractive therapeutic target in COVID-19.


Subject(s)
Aging , COVID-19/metabolism , Chitinase-3-Like Protein 1/metabolism , Aging/drug effects , Aminoglycosides/pharmacology , Aminoglycosides/therapeutic use , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/drug therapy , Cell Line, Tumor , Chitinase-3-Like Protein 1/antagonists & inhibitors , HEK293 Cells , Humans , SARS-CoV-2/physiology
19.
BMJ Open ; 11(11): e049928, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1501713

ABSTRACT

OBJECTIVES: Vaccine hesitancy may represent a barrier to effective COVID-19 immunisation campaigns. This study assesses individual, disease-specific and contextual factors associated with COVID-19 vaccine acceptance among a nationally representative sample of older Brazilian adults. DESIGN: Cross-sectional analysis of data from household interviews and a supplementary telephone survey. SETTING: Brazil and its five geographic regions. PARTICIPANTS: Data are derived from 6584 individuals aged 50 years and over who participated in the second wave of the Brazilian Longitudinal Study of Aging. PRIMARY AND SECONDARY OUTCOME MEASURES: Survey-weighted multinomial logistic regression assesses factors associated with intending, not intending or being uncertain about one's intention to vaccinate against COVID-19. FINDINGS: Seventy-one per cent of study participants intend to receive a COVID-19 vaccine once available, while 17% (representative of nearly 9 million people) have no intention to vaccinate, and 12% are still undecided. Besides age, demographic and health-related factors related to COVID-19 severity and complications were not associated with intention to vaccinate. Those who most trusted social media or friends and family for COVID-19 information and those who did not trust any information source were 68% and 78% more likely to refuse vaccination, respectively, as compared with those who trusted official information sources. People who inconsistently used face masks when outside were 3.4 times more likely than consistent face mask users to intend to refuse vaccination. Higher municipal COVID-19 fatality rates were negatively associated with vaccine refusal. CONCLUSIONS: Most national COVID-19 immunisation strategies identify older individuals as among those prioritised for early vaccination, given their increased risk of more severe symptoms and complications of the disease. Because individual, disease-specific, and contextual factors were associated with vaccine acceptance, there is a clear need for multilevel and multichannel information and outreach campaigns to increase COVID-19 vaccine acceptance among vulnerable older populations.


Subject(s)
COVID-19 , Vaccines , Adult , Aged , Aging , Brazil , COVID-19 Vaccines , Cross-Sectional Studies , Humans , Longitudinal Studies , Middle Aged , SARS-CoV-2 , Vaccination
20.
Stem Cells Transl Med ; 10(11): 1482-1490, 2021 11.
Article in English | MEDLINE | ID: covidwho-1490914

ABSTRACT

As our life expectancy increases, specific medical conditions appear, and new challenges are met in terms of global health. Frailty has become a medical and scientific concept to define pathologies where inflammation, depressed immune system, cellular senescence, and molecular aging converge. But more importantly, frailty is the ultimate cause of death that limits our life span and deteriorates health in an increasing proportion of the world population. The difficulty of tackling this problem is the combination of factors that influence frailty appearance, such as stem cells exhaustion, inflammation, loss of regeneration capability, and impaired immunomodulation. To date, multiple research fields have found mechanisms participating in this health condition, but to make progress, science will need to investigate frailty with an interdisciplinary approach. This article summarizes the current efforts to understand frailty from their processes mediated by inflammation, aging, and stem cells to provide a new perspective that unifies the efforts in producing advanced therapies against medical conditions in the context of frailty. We believe this approach against frailty is particularly relevant to COVID-19, since people in a state of frailty die more frequently due to the hyperinflammatory process associated with this infection.


Subject(s)
COVID-19 , Frailty , Inflammation/complications , Mesenchymal Stem Cell Transplantation , Aging/physiology , COVID-19/complications , COVID-19/therapy , Frailty/etiology , Frailty/therapy , Humans , Immunomodulation/physiology , Inflammation/therapy , Mesenchymal Stem Cell Transplantation/methods , Mesenchymal Stem Cell Transplantation/trends , Mesenchymal Stem Cells/physiology , Regeneration/physiology , SARS-CoV-2 , Signal Transduction/physiology
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