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年龄影响新冠病毒疾病(COVID-19)患者基于血细胞的免疫失调、抗体反应及不良临床结局。

Age influences blood cell-based immune deregulation antibody response and unfavorable clinical outcomes in COVID-19 patients.

作者信息

Tizazu Anteneh Mehari, Gize Addisu, Ali Solomon

机构信息

Department of Microbiology, Immunology and Parasitology, School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

CIHLMU Center for International Health, LMU University Hospital, LMU Munich, Germany.

出版信息

Sci Rep. 2025 May 20;15(1):17431. doi: 10.1038/s41598-025-95722-3.

Abstract

COVID-19 is caused by SARS-CoV-2 and has a diverse spectrum of clinical presentations ranging from asymptomatic cases to severe and critical cases that result in the death of the patient. Alongside the viral factors host factors like Age, deregulation of the immune response and presence of comorbidity determine the patient's outcome. Here we sought to assess the impact of age on natural antibody response, CBC-based inflammatory markers, and outcome of COVID-19 patients. We divided the participants into three groups, young (≤ 35 years), middle-aged (40-60 years), and old (≥ 65 years) patients and collected and analyzed sociodemographic, clinical, and laboratory parameters. We found that elderly patients showed higher (P < 0.05) levels of inflammation like increased neutrophil percentages, NLR, lymphopenia, and low Hgb levels, compared to middle-aged and young patients. Interestingly these markers were also associated with mortality of COVID-19 patients. On the other hand, no significant difference was observed in ion concentration, lipid profile, and coagulation test between the three age groups. We also found that elderly patients showed significantly (P < 0.05) decreased levels of natural antibody response to SARS-CoV-2 infection compared with the two groups. Lastly, we assessed the effect of dexamethasone treatment, even if statistically not significant (P > 0.05) we observed a positive trend among patients under dexamethasone in the aspect of decreasing inflammatory markers. To conclude we showed that SARS-CoV-2 is characterized by an age-dependent deregulation of inflammatory markers that are associated with mortality among COVID-19 patients.

摘要

新型冠状病毒肺炎(COVID-19)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,临床表现多样,从无症状感染到导致患者死亡的重症和危重症病例都有。除病毒因素外,年龄、免疫反应失调和合并症等宿主因素也决定了患者的预后。在此,我们试图评估年龄对COVID-19患者自然抗体反应、基于全血细胞计数的炎症标志物及预后的影响。我们将参与者分为三组,即年轻(≤35岁)、中年(40 - 60岁)和老年(≥65岁)患者,并收集和分析了社会人口统计学、临床和实验室参数。我们发现,与中年和年轻患者相比,老年患者的炎症水平更高(P < 0.05),如中性粒细胞百分比增加、中性粒细胞与淋巴细胞比值(NLR)升高、淋巴细胞减少和血红蛋白水平降低。有趣的是,这些标志物也与COVID-19患者的死亡率相关。另一方面,三个年龄组之间在离子浓度、血脂谱和凝血试验方面未观察到显著差异。我们还发现,与另外两组相比,老年患者对SARS-CoV-2感染的自然抗体反应水平显著降低(P < 0.05)。最后,我们评估了地塞米松治疗的效果,即使在统计学上不显著(P > 0.05),但我们观察到接受地塞米松治疗的患者在降低炎症标志物方面呈积极趋势。总之,我们表明SARS-CoV-2的特征是炎症标志物的年龄依赖性失调,这与COVID-19患者的死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f85/12092784/57af0af474f9/41598_2025_95722_Fig1_HTML.jpg

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