Astroth Corine, Shah Karishma S, Agrawal Sudhanshu, Agrawal Anshu
Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Irvine, CA 92697, USA.
Pathogens. 2025 Apr 3;14(4):346. doi: 10.3390/pathogens14040346.
SARS-CoV-2, first identified in December 2019, caused a global pandemic, resulting in over 6.8 million deaths by March 2023. The elderly, or individuals over 65, accounted for the majority of COVID-19 deaths, with 81% of fatalities in the US in 2020 occurring in this group. Beyond mortality, aging populations are also at higher risk of long-term cardiovascular complications and acute respiratory distress syndrome (ARDS). Although these outcomes may be influenced by comorbidities common in the elderly, age has been found to be a standalone risk factor for severe COVID-19 infection. Therefore, investigating age-related factors in COVID-19 outcomes is crucial in protecting this vulnerable group. Of particular interest is the cytokine storm phenomenon, an excessive inflammatory response that contributes to severe COVID-19 symptoms, including ARDS and cardiovascular damage. Elevated levels of multiple cytokines are common in severe cases of COVID-19. We propose that changes that occur to cytokine profiles as we age may contribute to these aberrant inflammatory responses. This review specifically explored the interleukin class cytokines IL-1, IL-6, IL-17, and IL-23 and considered the potential of biologics targeting these cytokines to alleviate severe outcomes in both COVID-19 and aging individuals.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）于2019年12月首次被发现，引发了全球大流行，截至2023年3月已导致超过680万人死亡。老年人，即65岁以上的个体，占新冠病毒疾病（COVID-19）死亡人数的大多数，2020年美国81%的死亡病例发生在这一群体中。除了死亡率，老龄化人口还面临更高的长期心血管并发症和急性呼吸窘迫综合征（ARDS）风险。尽管这些结果可能受到老年人常见的合并症影响，但年龄已被发现是严重COVID-19感染的一个独立风险因素。因此，研究COVID-19结局中与年龄相关的因素对于保护这一弱势群体至关重要。特别令人感兴趣的是细胞因子风暴现象，这是一种过度的炎症反应，会导致严重的COVID-19症状，包括ARDS和心血管损伤。在COVID-19重症病例中，多种细胞因子水平升高很常见。我们认为，随着年龄增长细胞因子谱发生的变化可能导致这些异常的炎症反应。本综述特别探讨了白细胞介素类细胞因子白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、白细胞介素-17（IL-17）和白细胞介素-23（IL-23），并考虑了靶向这些细胞因子的生物制剂减轻COVID-19和老年人严重结局的潜力。
