Potential determinants of age-related severity in COVID-19

Abstract

Global pandemics have emerged from time-to-time duringthe history of the human species. In this regard, the recentoutbreak of the corona virus disease 19 (COVID-19)probably represents the most significant public healthemergency ever faced since the beginning of the modernera due to its dramatic impact on the health, the economy,and the quality of life of the societies worldwide. In thiscontext, the understanding of the main possible factorsbehind the age-related increased morbidity in COVID-19seems crucial to yield insights into pathogenesis and theinformed management and to design new therapeuticapproaches personalized to different patient profiles.Among these factors, the possible changes in angiotensinconvertingenzyme 2 expression and local angiotensinmetabolism in the lung, the chronic low-gradeinflammation and changes in the innate and adaptiveimmune system, and physiological and anatomical changesof the respiratory system that are developed with age haveprobably a crucial role. Besides, other changes inherent toage, such as muscular sarcopenia or diminished gasexchange in the alveoli, may play a role in facilitating the badprognosis of the disease. Thus, here I summarize the mostimportant changes that may drive the increased risk ofsuffering life-threatening complications with age inCOVID-19.