Rosero Christian I, Gravenstein Stefan, Saade Elie A
Meadville Medical Center, Meadville, PA, 16335, USA.
Brown University School of Public Health, Providence, RI, 02903, USA.
Drugs Aging. 2025 Jan;42(1):39-55. doi: 10.1007/s40266-024-01169-y. Epub 2025 Jan 7.
Influenza, a highly contagious respiratory viral illness, poses significant global health risks, particularly affecting older and those with chronic health conditions. Influenza viruses, primarily types A and B, are responsible for seasonal human infections and exhibit a propensity for antigenic drift and shift, contributing to seasonal epidemics and pandemics. The severity of influenza varies, but severe cases often lead to pneumonia, acute respiratory distress syndrome, and multiorgan failure. Older adults, especially those over 65 years of age, face increased risks of immune senescence, chronic comorbidities, and decreased vaccine efficacy. Globally, influenza affects millions of people annually, with significant morbidity and mortality among older. Epidemiological patterns vary with climate, and risk factors include age, immunocompromised status, and preexisting chronic conditions. In older adults, influenza frequently results in hospitalization and death, which is exacerbated by immunosenescence and biological organ changes associated with aging. Clinical manifestations range from mild symptoms to severe complications such as viral pneumonia and multiorgan failure. Diagnosis often relies on antigen or molecular tests, with radiological examination aiding in severe cases. Treatment primarily involves antiviral agents, such as oseltamivir and peramivir, with the greatest benefit observed when initiated early. Management of severe cases may require hospitalization and supportive care, including addressing complications, such as secondary bacterial infections and cardiovascular events. This article highlights the need for improved vaccination strategies and novel treatments, including monoclonal antibodies and adoptive T cell therapies, to better manage severe influenza infections in vulnerable populations such as older.
流感是一种具有高度传染性的呼吸道病毒性疾病，对全球健康构成重大风险，尤其影响老年人和患有慢性健康问题的人群。流感病毒主要是甲型和乙型，是导致季节性人类感染的原因，并且具有抗原漂移和转变的倾向，这导致了季节性流行和大流行。流感的严重程度各不相同，但严重病例通常会导致肺炎、急性呼吸窘迫综合征和多器官衰竭。老年人，尤其是65岁以上的老年人，面临免疫衰老、慢性合并症增加以及疫苗效力下降的风险。在全球范围内，流感每年影响数百万人，老年人中发病率和死亡率都很高。流行病学模式因气候而异，风险因素包括年龄、免疫功能低下状态和既往存在的慢性疾病。在老年人中，流感经常导致住院和死亡，免疫衰老以及与衰老相关的生物器官变化会加剧这种情况。临床表现从轻微症状到严重并发症，如病毒性肺炎和多器官衰竭不等。诊断通常依赖于抗原或分子检测，严重病例中放射学检查有辅助作用。治疗主要涉及抗病毒药物，如奥司他韦和帕拉米韦，早期开始使用时效果最佳。严重病例的管理可能需要住院和支持性护理，包括处理并发症，如继发性细菌感染和心血管事件。本文强调需要改进疫苗接种策略和开发新的治疗方法，包括单克隆抗体和过继性T细胞疗法，以更好地管理老年人等脆弱人群中的严重流感感染。
