A public health perspective of aging: do hyper-inflammatory syndromes such as COVID-19, SARS, ARDS, cytokine storm syndrome, and post-ICU syndrome accelerate short- and long-term inflammaging?

Abstract

A central clinical question as the world deals with the COVID-19 pandemic is what the long-term sequelae for the millions of individuals will be who recover from the hyperinflammatory state characterizing COVID-19 and in particular for the hundreds of thousands who are ill enough to need hospitalization and in particular ICU care. Even when the pandemic is finally controlled, will COVID-19 survivors face exaggerated internal inflammatory processes, worsening co-morbidities, and increased susceptibility to age-related diseases? Clues for what may happen in post-COVID-19 patients can be elicited from those who recovered from other conditions that lead to similar hyperinflammatory states such as Severe Acute Respiratory Syndrome (SARS), acute respiratory disease syndrome (ARDS), cytokine storm syndrome, and post-ICU syndrome. The short-and long-term sequalae following recovery from each of these conditions suggests that these syndromes lead to an accelerated state of chronic subclinical systemic inflammation often seen in aging (termed inflammaging) resulting in increased and worsening age-related conditions including frailty even in younger individuals.

Gibt es ein Post-COVID-Syndrom?

“…Eine Hypothese in diesem Zusammenhang ist, dass ein Post-COVID-Syndrom mit einer chronischen subklinischen systemischen Entzündung (Inflammation) einhergehen könnte, wie dies im Alterungsprozess (Aging) beobachtbar ist. Dieses "Inflammaging" könnte das Potenzial haben, bestehende Komorbiditäten zu verschlechtern und altersabhängige Probleme zu verstärken [12].…”

“…Diese als "Zytokinsturm" bezeichnete schwere, systemische Inflammation wird übrigens in allen Altersgruppen beobachtet, bei Kindern wurde eine schwere Multisysteminflammation mit Ähnlichkeiten zum Kawasaki-Syndrom vielfach beschrieben. Hält eine Entzündungsreaktion jedoch über lange Zeit an, so wird angenommen, dass dies zu zellulärer Seneszenz mit Hemmung der Zellproliferation und Resistenz gegenüber Apoptose führt [12].…”

Exercise Training and Cardiac Rehabilitation in COVID-19 Patients with Cardiovascular Complications: State of Art

“…Physical exercise, correctly structured and guided or supervised, intervenes in this inflammatory state by promoting the recovery of the antioxidant defenses [ 7 ].…”

It's not over till it's over: a narrative review of Long COVID

“…The plasticity of the immune system preserves an individual record or biography of the individual's experiences and continuous adaptation to pathogens. Thus, immunobiography can help explain the genetic contributions to differences in immune systems and may explain sex-based differences as well [53,55]. Since the immune system undergoes remodeling with advancing age, the aging body becomes more and more vulnerable to infections, malignancies, and autoimmune disorders [56].…”