Older patients affected by COVID-19: investigating the existence of biological phenotypes.

IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Alberto Zucchelli, Marta Parigi, Silvia Giliani, Davide Liborio Vetrano, Daniela Lucente, Emanuele Marzetti, Riccardo Calvani, Giuseppe Bellelli, Alessandra Marengoni
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Abstract

Introduction: COVID-19 provides an opportunity to examine biological phenotypes (observable morphological, functional and biological characteristics) in individuals who experience the same acute condition, potentially revealing differences in response to acute external stressors. The aim our study was to investigate biological phenotypes in older patients hospitalized for COVID-19, exploiting a panel of aging biomarkers.

Methods: Data were gathered from the FRACOVID Project, an observational multicenter study, aimed to evaluate the impact of frailty on health-related outcomes in patients 60 + with COVID-19 in Northern Italy. A hierarchical cluster analysis was run using log-transformed and scaled values of TNF-a, IL-1 beta, IL-6, PAI-1, GDF-15, NT-proBNP, and Cystatin C evaluated at admission.

Results: Eighty-one participants (mean age 75.3 years; 60.5% male) were evaluated. Frailty was identified in 42% of the sample and 27.2% were unable to ambulate outdoors. The mean hospital stay was 24.7 days, with an in-hospital mortality rate of 18.5%. Three biological phenotypes were found: (1) 'inflammatory', with high inflammatory biomarkers; (2) 'organ dysfunction', characterized by elevated cystatin C and NT-proBNP, and lower inflammatory markers; and (3) 'unspecific', with lower NT-proBNP and GDF-15 levels, and intermediate concentrations of other biomarkers. The 'organ dysfunction' phenotype showed the highest mean age and prevalence of frailty, disability, and chronic diseases. The 'inflammatory' phenotype showed the highest burden of respiratory and systemic signs and symptoms of infection.

Conclusion: Biological phenotypes might be used to identify different clinical and functional phenotypes in individuals affected by COVID-19.

受 COVID-19 影响的老年患者:研究生物表型的存在。
简介:COVID-19 为研究经历相同急性病的个体的生物表型(可观察到的形态、功能和生物特征)提供了机会,有可能揭示对急性外部应激反应的差异。我们的研究旨在利用一组老化生物标志物,调查因 COVID-19 住院的老年患者的生物表型:该项目是一项多中心观察性研究,旨在评估意大利北部 60 岁以上 COVID-19 患者的虚弱对健康相关结果的影响。利用入院时评估的 TNF-a、IL-1 beta、IL-6、PAI-1、GDF-15、NT-proBNP 和胱抑素 C 的对数变换和比例值进行了分层聚类分析:对 81 名参与者(平均年龄 75.3 岁;60.5% 为男性)进行了评估。42%的受试者体质虚弱,27.2%的受试者无法在户外行走。平均住院时间为 24.7 天,院内死亡率为 18.5%。研究发现了三种生物表型:(1) "炎症性",炎症性生物标志物较高;(2) "器官功能障碍",胱抑素 C 和 NT-proBNP 升高,炎症性标志物较低;(3) "非特异性",NT-proBNP 和 GDF-15 水平较低,其他生物标志物浓度居中。器官功能障碍 "表型的平均年龄最高,体弱、残疾和慢性病的发病率也最高。炎症 "表型显示呼吸道和全身感染症状和体征的负担最重:生物表型可用于识别 COVID-19 患者的不同临床和功能表型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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