Purpose

Novel Coronavirus disease 2019 (COVID-19), is an acute respiratory distress syndrome (ARDS), which is emerged in Wuhan, and recently become worldwide pandemic. Strangely, ample evidences have been shown that the severity of COVID-19 infections varies widely from children (asymptomatic), adults (mild infection), as well as elderly adults (deadly critical). It has proven that COVID-19 infection in some elderly critical adults leads to a cytokine storm, which is characterized by severe systemic elevation of several pro-inflammatory cytokines. Then, a cytokine storm can induce edematous, ARDS, pneumonia, as well as multiple organ failure in aged patients. It is far from clear till now why cytokine storm induces in only COVID-19 elderly patients, and not in young patients. However, it seems that aging is associated with mild elevated levels of local and systemic pro-inflammatory cytokines, which is characterized by “inflamm-aging”. It is highly likely that “inflamm-aging” is correlated to increased risk of a cytokine storm in some critical elderly patients with COVID-19 infection.

Methods

A systematic search in the literature was performed in PubMed, Scopus, Embase, Cochrane Library, Web of Science, as well as Google Scholar pre-print database using all available MeSH terms for COVID-19, Coronavirus, SARS-CoV-2, senescent cell, cytokine storm, inflame-aging, ACE2 receptor, autophagy, and Vitamin D. Electronic database searches combined and duplicates were removed.

Results

The aim of the present review was to summarize experimental data and clinical observations that linked the pathophysiology mechanisms of “inflamm-aging”, mild-grade inflammation, and cytokine storm in some elderly adults with severe COVID-19 infection.

中文翻译：

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COVID-19感染老年人细胞因子风暴可能的病理生理机制：“炎症衰老”的贡献。

目的

新型冠状病毒病 2019 (COVID-19) 是一种急性呼吸窘迫综合征 (ARDS)，在武汉出现，最近成为全球大流行病。奇怪的是，大量证据表明，COVID-19 感染的严重程度在儿童（无症状）、成人（轻度感染）和老年人（重症）之间差异很大。已经证明，COVID-19 在一些危重老年患者中的感染会导致细胞因子风暴，其特征是几种促炎细胞因子在全身严重升高。然后，细胞因子风暴可诱发老年患者水肿、ARDS、肺炎以及多器官功能衰竭。目前还不清楚为什么细胞因子风暴只在 COVID-19 老年患者中诱发，而在年轻患者中没有。然而，似乎衰老与局部和全身促炎细胞因子水平轻度升高有关，其特征是“炎症衰老”。在一些感染 COVID-19 的危重老年患者中，“炎症老化”很可能与细胞因子风暴风险增加相关。

方法

在 PubMed、Scopus、Embase、Cochrane Library、Web of Science 以及 Google Scholar 预印本数据库中使用 COVID-19、冠状病毒、SARS-CoV-2、衰老的所有可用 MeSH 术语对文献进行了系统搜索细胞、细胞因子风暴、炎症老化、ACE2 受体、自噬和维生素 D。合并了电子数据库搜索并删除了重复项。

结果

本综述的目的是总结实验数据和临床观察结果，这些数据和临床观察结果将一些患有严重 COVID-19 感染的老年人的“炎症老化”、轻度炎症和细胞因子风暴的病理生理学机制联系起来。