INTRODUCTION: Chronological age (CA) is a predictor of adverse COVID-19 outcomes; however, CA alone has not shown to be the better predictor of adverse outcomes in COVID-19 as it does not capture individual responses to SARS-CoV-2 infection. Here, we evaluated the influence of aging metrics PhenoAge and PhenoAccelAge on the adaptive responses to SARS-CoV-2 infection in hospitalized patients. METHODS: We assessed cases admitted to a COVID-19 reference center in Mexico City. PhenoAge and PhenoAccelAge were estimated using laboratory values at admission. Cox proportional hazards models were fitted to estimate risk for COVID-19 lethality and adverse outcomes (ICU admission, intubation, or death), and k-means clustering was performed to explore reproducible patterns of adaptive response to SARS-CoV-2 infection using PhenoAge components. RESULTS: We included 1069 subjects of whom 401 presented critical illness and 204 died. PhenoAge was a better predictor of adverse outcomes and lethality compared to CA and SpO2 and its predictive capacity was sustained for all age groups. Patients with responses associated PhenoAccelAge >0 had higher risk of death and critical illness compared to those who had values according to CA (log-rank p<0.001). Using unsupervised clustering we identified four adaptive responses to SARS-CoV-2 infection: 1) Inflammaging associated with CA, 2) adaptive metabolic dysfunction associated with cardio-metabolic comorbidities, 3) adaptive unfavorable hematological response, and 4) response associated with favorable outcomes. CONCLUSIONS: Adaptive responses related to accelerated aging metrics are linked to adverse COVID-19 outcomes and have unique and distinguishable features. PhenoAge is a better predictor of adverse outcomes compared to CA.

Introduction and Objectives : The emergence of SARS-CoV-2, which causes the coronavirus disease (COVID-19) has caused a great impact on healthcare systems worldwide, including hepatitis B and C viruses screening and elimination programs. The high number of COVID-19 hospitalizations represent a great opportunity to screen patients for hepatitis B virus (HBV) and hepatitis C virus (HCV), which was the aim of this study. Material and Methods : Cross-sectional, retrospective study performed between April 2020 and 20201 at a referral center in Mexico dedicated to the care of adults with severe/critical COVID-19. We retrieved clinical, demographic, and laboratory results from each patient´s medical records, including antibodies against HCV (anti-HCV), HBV surface antigen (HBsAg), antibodies against the HBV core antigen (anti-HBcAg), and antibodies against HBsAg (anti-HBsAg). Results : Out of 3620 patients that were admitted to the hospital, 24 (0.66%), 4 (0.11%), and 72 (1.99%) tested positive for anti-HCV, HBsAg, and anti-HBcAg, respectively. Of all seronegative patients, 954 (27%) had undetectable anti-HBsAg and 401 (12%) had anti-HBsAg at protective levels. Surgeries and blood transfusions were the most relevant risk factors. Only 9.7% of the anti-HBc positive, 25% of the HBsAg positive, and 52% of the anti-HCV positive were aware of their serological status. Conclusions : In this study we found a prevalence of anti-HCV of 0.66%, of HBsAg of 0.11%, and of isolated anti-HBcAg of 1.88%. We also found that HBV vaccination coverage has been suboptimal and needs to be reinforced. This study gave us a trustworthy insight of the actual seroprevalence in Mexico, which can help provide feedback to the Hepatitis National Elimination Plan.