Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11557
COVID-19: age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study
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ISSN: 1742-4933
WOS ID: 000564147600001
Scopus EID: 2-s2.0-85089918549
PMID: 32802142
Embase PUI: L632573657
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Jurado, Aurora; Martin, Maria C.; Abad-Molina, Cristina; Orduna, Antonio; Martinez, Alba; Ocana, Esther; Yarce, Oscar; Navas, Ana M.; Trujillo, Antonio; Fernandez, Luis; Vergara, Esther; Rodriguez, Beatriz; Quirant, Bibiana; Martinez-Caceres, Eva; Hernandez, Manuel; Perurena-Prieto, Janire; Gil, Juana; Cantenys, Sergi; Gonzalez-Martinez, Gema; Martinez-Saavedra, Maria T.; Rojo, Ricardo; Marco, Francisco M.; Mora, Sergio; Ontanon, Jesus; Lopez-Hoyos, Marcos; Ocejo-Vinyals, Gonzalo; Melero, Josefa; Aguilar, Marta; Almeida, Delia; Medina, Silvia; Vegas, Maria C.; Jimenez, Yesenia; Prada, Alvaro; Monzon, David; Boix, Francisco; Cunill, Vanesa; Molina, JuanPublication date
2020-08-14Document type
research articleCitation
Jurado A, Martin MC, Abad-Molina C, Orduna A, Martinez A, Ocana E, et al. COVID-19: age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study. Immun Ageing. 2020 Aug 14;17(1):22.Abstract
Background The SARS-CoV-2 infection has widely spread to become the greatest public health challenge to date, the COVID-19 pandemic. Different fatality rates among countries are probably due to non-standardized records being carried out by local health authorities. The Spanish case-fatality rate is 11.22%, far higher than those reported in Asia or by other European countries. A multicentre retrospective study of demographic, clinical, laboratory and immunological features of 584 Spanish COVID-19 hospitalized patients and their outcomes was performed. The use of renin-angiotensin system blockers was also analysed as a risk factor. Results In this study, 27.4% of cases presented a mild course, 42.1% a moderate one and for 30.5% of cases, the course was severe. Ages ranged from 18 to 98 (average 63). Almost 60 % (59.8%) of patients were male. Interleukin 6 was higher as severity increased. On the other hand, CD8 lymphocyte count was significantly lower as severity grew and subpopulations CD4, CD8, CD19, and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 lymphocytes was found in males. The use of angiotensin-converting enzyme inhibitors was associated with a better prognosis. The angiotensin II receptor blocker use was associated with a more severe course. Conclusions Age and age-related comorbidities, such as dyslipidaemia, hypertension or diabetes, determined more frequent severe forms of the disease in this study than in previous literature cohorts. Our cases are older than those so far reported and the clinical course of the disease is found to be impaired by age. Immunosenescence might be therefore a suitable explanation for the hampering of immune system effectors. The adaptive immunity would become exhausted and a strong but ineffective and almost deleterious innate response would account for COVID-19 severity. Angiotensin-converting enzyme inhibitors used by hypertensive patients have a protective effect in regards to COVID-19 severity in our series. Conversely, patients on angiotensin II receptor blockers showed a severer disease.
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https://dx.doi.org/10.1186/s12979-020-00194-wKeywords
Severe acute respiratory syndrome coronavirus 2COVID-19
Immunosenescence
Immunity
Renin-angiotensin system
ACE2
Interleukin-6
C-reactive protein
Lymphocytes
Spain