The COVID-19 pandemic caused by SARS-CoV-2 infection has been of unprecedented clinical and socio-economic worldwide relevance. The case fatality rate for COVID-19 grows exponentially with age and the presence of comorbidities. In the older patients, COVID-19 manifests predominantly as a systemic disease associated with immunological, inflammatory, and procoagulant responses. Timely diagnosis and risk stratification are crucial steps to define appropriate therapies and reduce mortality, especially in the older patients. Chronically and systemically activated innate immune responses and impaired antiviral responses have been recognized as the results of a progressive remodeling of the immune system during aging, which can be described by the words ‘immunosenescence’ and ‘inflammaging’. These age-related features of the immune system were highlighted in patients affected by COVID-19 with the poorest clinical outcomes, suggesting that the mechanisms underpinning immunosenescence and inflammaging could be relevant for COVID-19 pathogenesis and progression. Increasing evidence suggests that senescent myeloid and endothelial cells are characterized by the acquisition of a senescence-associated pro-inflammatory phenotype (SASP), which is considered as the main culprit of both immunosenescence and inflammaging. Here, we reviewed this evidence and highlighted several circulating biomarkers of inflammaging that could provide additional prognostic information to stratify COVID-19 patients based on the risk of severe outcomes.

由 SARS-CoV-2 感染引起的 COVID-19 大流行在全球范围内具有前所未有的临床和社会经济相关性。COVID-19 的病死率随着年龄和合并症的出现呈指数增长。在老年患者中，COVID-19 主要表现为与免疫、炎症和促凝血反应相关的全身性疾病。及时诊断和风险分层是确定适当疗法和降低死亡率的关键步骤，尤其是对于老年患者。慢性和全身激活的先天免疫反应和受损的抗病毒反应已被认为是衰老过程中免疫系统进行性重塑的结果，可以用“免疫衰老”和“炎症”来描述。免疫系统的这些与年龄相关的特征在受 COVID-19 影响且临床结果最差的患者中得到强调，这表明支持免疫衰老和炎症的机制可能与 COVID-19 的发病机制和进展相关。越来越多的证据表明，衰老的骨髓细胞和内皮细胞的特征是获得了衰老相关的促炎表型 (SASP)，这被认为是免疫衰老和炎症的罪魁祸首。在这里，我们回顾了这一证据，并强调了几种循环的炎症生物标志物，这些标志物可以提供额外的预后信息，以根据严重后果的风险对 COVID-19 患者进行分层。表明支持免疫衰老和炎症的机制可能与 COVID-19 的发病机制和进展有关。越来越多的证据表明，衰老的骨髓细胞和内皮细胞的特征是获得了衰老相关的促炎表型 (SASP)，这被认为是免疫衰老和炎症的罪魁祸首。在这里，我们回顾了这一证据，并强调了几种循环的炎症生物标志物，这些标志物可以提供额外的预后信息，以根据严重后果的风险对 COVID-19 患者进行分层。表明支持免疫衰老和炎症的机制可能与 COVID-19 的发病机制和进展有关。越来越多的证据表明，衰老的骨髓细胞和内皮细胞的特征是获得了衰老相关的促炎表型 (SASP)，这被认为是免疫衰老和炎症的罪魁祸首。在这里，我们回顾了这一证据，并强调了几种循环的炎症生物标志物，这些标志物可以提供额外的预后信息，以根据严重后果的风险对 COVID-19 患者进行分层。越来越多的证据表明，衰老的骨髓细胞和内皮细胞的特征是获得了衰老相关的促炎表型 (SASP)，这被认为是免疫衰老和炎症的罪魁祸首。在这里，我们回顾了这一证据，并强调了几种循环的炎症生物标志物，这些标志物可以提供额外的预后信息，以根据严重后果的风险对 COVID-19 患者进行分层。越来越多的证据表明，衰老的骨髓细胞和内皮细胞的特征是获得了衰老相关的促炎表型 (SASP)，这被认为是免疫衰老和炎症的罪魁祸首。在这里，我们回顾了这一证据，并强调了几种循环的炎症生物标志物，这些标志物可以提供额外的预后信息，以根据严重后果的风险对 COVID-19 患者进行分层。