Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, Moscow 129226, Russian Federation.
Federal State Autonomous Educational Institution of Higher Education "Peoples' Friendship University of Russia" (RUDN University), Department of Internal Medicine, Moscow 117198, Russian Federation.
Aging (Albany NY). 2022 Feb 25;14(4):1611-1626. doi: 10.18632/aging.203915.
Old age is a crucial risk factor for severe coronavirus disease 2019 (COVID-19), with serious or fatal outcomes disproportionately affecting older adults compared with the rest of the population. We proposed that the physiological health status and biological age, beyond the chronological age itself, could be the driving trends affecting COVID-19 severity and mortality. A total of 155 participants hospitalized with confirmed COVID-19 aged 26-94 years were recruited for the study. Four different physiological summary indices were calculated: Klemera and Doubal's biological age, PhenoAge, physiological dysregulation (PD; globally and in specific systems), and integrated albunemia. All of these indices significantly predicted the risk of death (p < 0.01) after adjusting for chronological age and sex. In all models, men were 2.4-4.4-times more likely to die than women. The global PD was shown to be a good predictor of deterioration, with the odds of deterioration increasing by 41.7% per 0.5-unit increase in the global PD. As for death, the odds also increased by 68.3% per 0.5-unit increase in the global PD. Our results are partly attributed to common chronic diseases that aggravate COVID-19, but they also suggest that the underlying physiological state could capture vulnerability to severe COVID-19 and serve as a tool for prognosis that would, in turn, help inpatient management.
衰老（ageing）是导致 2019 年冠状病毒病（coronavirus disease 2019，COVID-19）重症的关键危险因素，与其他人群相比，严重或致命结局在老年人中更为常见。我们提出，生理健康状况和生物年龄（超越实际年龄本身）可能是影响 COVID-19 严重程度和死亡率的驱动趋势。这项研究共招募了 155 名年龄在 26-94 岁之间、因确诊 COVID-19 而住院的患者。计算了 4 种不同的生理综合指数：Klemera 和 Doubal 的生物年龄、PhenoAge、生理失调（PD；全身性和特定系统）和整合性 Albunemia。在调整了实际年龄和性别后，所有这些指数均显著预测了死亡风险（p<0.01）。在所有模型中，男性死亡的可能性是女性的 2.4-4.4 倍。全身性 PD 是疾病恶化的良好预测指标，全身性 PD 每增加 0.5 个单位，恶化的几率增加 41.7%。至于死亡，全身性 PD 每增加 0.5 个单位，死亡的几率也增加 68.3%。我们的结果部分归因于加重 COVID-19 的常见慢性疾病，但这也表明潜在的生理状态可以捕捉到 COVID-19 重症的脆弱性，并作为预后工具，从而有助于住院患者管理。
