SARS-CoV-2 and COVID-19 in older adults: what we may expect regarding pathogenesis, immune responses, and outcomes
Open accessAbstract
SARS-CoV-2 virus, the causative agent of the coronavirus infectious disease-19 (COVID-19), is taking the globe by storm, approaching 500,000 confirmed cases and over 21,000 deaths as of March 25, 2020. While under control in some affected Asian countries (Taiwan, Singapore, Vietnam), the virus demonstrated an exponential phase of infectivity in several large countries (China in late January and February and many European countries and the USA in March), with cases exploding by 30-50,000/day in the third and fourth weeks of March, 2020. SARS-CoV-2 has proven to be particularly deadly to older adults and those with certain underlying medical conditions, many of whom are of advanced age. Here, we briefly review the virus, its structure and evolution, epidemiology and pathogenesis, immunogenicity and immune, and clinical response in older adults, using available knowledge on SARS-CoV-2 and its highly pathogenic relatives MERS-CoV and SARS-CoV-1. We conclude by discussing clinical and basic science approaches to protect older adults against this disease.
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These age-related immunological changes weaken responses to most viruses and leave elderly people especially vulnerable to influenza, SARS-CoV-2 and other lethal coronaviruses.
“These immunological changes weaken the immune responses to most viruses, leaving the elderly particularly vulnerable to influenza, SARS-CoV-2, and other lethal coronaviruses, such as SARS-CoV-1 and Middle East Respiratory Syndrome (MERS)-CoV31.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [31]
Ageing leads to a delay in type I interferon responses linked to changes in viral sensing, a delay also seen in SARS-CoV-1.
“Ageing leads to a delay in type I IFN responses, linked to changes in viral sensing, which was also seen in SARS-CoV-131.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [31]
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- Authors
- Nikolich-Zugich, J., Knox, K. S., Rios, C. T., Natt, B., Bhattacharya, D., & Fain, M. J.
- Affiliations
- University of Arizona (US)
- Venue
- GeroScience
- Published
- 2020-04
- Volume
- 42
- Issue
- 2
- Pages
- 505-514
- ISSN
- 2152-4041 (ISSN-L)
- 2509-2715
- 2509-2723
- PMC
- PMC7145538
- OpenAlex
- W3015835940
- Cited by
- 577
- References
- 70
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 42 · 2023: 51 · 2022: 91 · 2021: 179 · 2020: 186 · 2018: 2
- FWCI
- 5.99
- Type
- journal article
- Language
- en
- Update notices
- correction (2020-05-03)
- Open access
- bronze
- doi.org
- Locations
- GeroScience (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- SARS-CoV-2, COVID-19 pandemic, older adults, pathogenesis, immune response, immunogenicity, clinical outcomes, viral evolution, MERS-CoV, SARS-CoV-1, disease severity, infection control
- MeSH terms
- Immunosenescence, Betacoronavirus, Angiotensin-Converting Enzyme 2, COVID-19, SARS-CoV-2, Aged, Animals, Antibodies, Viral, Fever, Geriatrics, Humans, Peptidyl-Dipeptidase A, Pneumonia, Viral, Cytokines, Coronavirus Infections, Chemokines, Severe acute respiratory syndrome-related coronavirus, Pandemics, Spike Glycoprotein, Coronavirus, Middle East Respiratory Syndrome Coronavirus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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