Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy.
Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Ageing Res Rev. 2022 Nov;81:101686. doi: 10.1016/j.arr.2022.101686. Epub 2022 Jul 9.
The post-acute COVID-19 syndrome (PACS) is characterized by the persistence of fluctuating symptoms over three months from the onset of the possible or confirmed COVID-19 acute phase. Current data suggests that at least 10% of people with previously documented infection may develop PACS, and up to 50-80% of prevalence is reported among survivors after hospital discharge. This viewpoint will discuss various aspects of PACS, particularly in older adults, with a specific hypothesis to describe PACS as the expression of a modified aging trajectory induced by SARS CoV-2. This hypothesis will be argued from biological, clinical and public health view, addressing three main questions: (i) does SARS-CoV-2-induced alterations in aging trajectories play a role in PACS?; (ii) do people with PACS face immuno-metabolic derangements that lead to increased susceptibility to age-related diseases?; (iii) is it possible to restore the healthy aging trajectory followed by the individual before pre-COVID?. A particular focus will be given to the well-being of people with PACS that could be assessed by the intrinsic capacity model and support the definition of the healthy aging trajectory.
新冠病毒感染后综合征（PACS）的特征是，从可能或确诊的 COVID-19 急性期发病起，持续出现波动症状，时间超过三个月。目前的数据表明，至少有 10%的有记录感染的人可能会发展为 PACS，而在出院后的幸存者中，发病率高达 50-80%。本观点将讨论 PACS 的各个方面，特别是在老年人中，并提出一个假设，将 PACS 描述为 SARS CoV-2 诱导的衰老轨迹的改变。这一假设将从生物学、临床和公共卫生的角度进行论证，涉及三个主要问题：(i) SARS-CoV-2 诱导的衰老轨迹改变是否在 PACS 中起作用？；(ii) 患有 PACS 的人是否面临导致与年龄相关疾病易感性增加的免疫代谢紊乱？；(iii) 是否有可能恢复个体在 COVID 之前所遵循的健康衰老轨迹？。将特别关注 PACS 患者的健康状况，这可以通过内在能力模型进行评估，并支持健康衰老轨迹的定义。
