Clinical experience thus far indicates that COVID-19 is highly heterogeneous, ranging from being asymptomatic and mild to severe and causing death. Host factors including age, sex, and comorbid conditions are key determinants of disease severity and progression. Aging itself is a prominent risk factor for severe disease and death from COVID-19. We hypothesize that age-related decline and dysregulation of immune function, i.e., immunosenescence and inflammaging play a major role in contributing to heightened vulnerability to severe COVID-19 outcomes in older adults.
Chen, Y., Klein, S. L., Garibaldi, B. T., Li, H., Wu, C., Osevala, N. M., Li, T., Margolick, J. B., Pawelec, G., & Leng, S. X. (2021). Aging in COVID-19: Vulnerability, immunity and intervention. Ageing research reviews, 65, 101205.
We know that certain conditions increase ones risk related to the outcome of COVID. In this case series that included 5700 patients hospitalized with COVID-19 in the New York City area, the most common comorbidities were hypertension, obesity, and diabetes. This study describes the demographics, baseline comorbidities, presenting clinical tests, and outcomes of the first sequentially hospitalized patients with COVID-19 from an academic health care system in New York. Really interesting.
Richardson, S., Hirsch, J. S., Narasimhan, M., Crawford, J. M., McGinn, T., Davidson, K. W., the Northwell COVID-19 Research Consortium, Barnaby, D. P., Becker, L. B., Chelico, J. D., Cohen, S. L., Cookingham, J., Coppa, K., Diefenbach, M. A., Dominello, A. J., Duer-Hefele, J., Falzon, L., Gitlin, J., Hajizadeh, N., Harvin, T. G., … Zanos, T. P. (2020). Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA, 323(20), 2052–2059.
The early data from China suggested that a majority of coronavirus disease 2019 (COVID-19) deaths have occurred among adults aged ≥60 years and among persons with serious underlying health conditions. We have come to understand that age is a factor in predicting outcomes.
CDC COVID-19 Response Team (2020). Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR. Morbidity and mortality weekly report, 69(12), 343–346.
This is a fascinating study discussing blood types and outcomes. Interesting outcomes such as increased infection prevalence among non-O types. Risk of intubation was decreased among A and increased among AB and B types, compared with type O, while risk of death was increased for type AB and decreased for types A and B. I wonder going forward if we will find more connections related to genetics, blood types, immune health and such related to outcomes with COVID 19.
Zietz, M., Zucker, J., & Tatonetti, N. P. (2020). Associations between blood type and COVID-19 infection, intubation, and death. Nature communications, 11(1), 5761.
Many have suggested the involvement of vitamin D in reducing the risk of infections. Is vitamin D supplementation a useful measure to reduce the risk of infection? Perhaps.
D'Avolio, A., Avataneo, V., Manca, A., Cusato, J., De Nicolò, A., Lucchini, R., Keller, F., & Cantù, M. (2020). 25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2. Nutrients, 12(5), 1359.
Grant, W. B., Lahore, H., McDonnell, S. L., Baggerly, C. A., French, C. B., Aliano, J. L., & Bhattoa, H. P. (2020).
This is a great article discussing the functional medicine approach to the COVID-19 virus.
The Institute for Functional Medicine. Updated 12.20.2020.
This is a look at lingering symptoms related to COVID-19. This study found that in patients who had recovered from COVID-19, 87.4% reported persistence of at least 1 symptom, particularly fatigue and shortness of breath or labored breathing. There is much discussion about lingering symptoms or “long haulers syndrome”. These studies speak to this, there are many thoughts on the extent of long term effects and the root of this.
Carfì, A., Bernabei, R., Landi, F., & Gemelli Against COVID-19 Post-Acute Care Study Group (2020). Persistent Symptoms in Patients After Acute COVID-19. JAMA, 324(6), 603–605. Advance online publication.
Garg, P., Arora, U., Kumar, A., & Wig, N. (2021). The "post-COVID" syndrome: How deep is the damage? Journal of medical virology, 93(2), 673–674.
Afrin, L. B., Weinstock, L. B., & Molderings, G. J. (2020). Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 100, 327–332.
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