RT Journal Article
T1 COVID-19: age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study.
A1 Jurado, Aurora
A1 Martín, María C
A1 Abad-Molina, Cristina
A1 Orduña, Antonio
A1 Martínez, Alba
A1 Ocaña, Esther
A1 Yarce, Oscar
A1 Navas, Ana M
A1 Trujillo, Antonio
A1 Fernández, Luis
A1 Vergara, Esther
A1 Rodríguez, Beatriz
A1 Quirant, Bibiana
A1 Martínez-Cáceres, Eva
A1 Hernández, Manuel
A1 Perurena-Prieto, Janire
A1 Gil, Juana
A1 Cantenys, Sergi
A1 González-Martínez, Gema
A1 Martínez-Saavedra, María T
A1 Rojo, Ricardo
A1 Marco, Francisco M
A1 Mora, Sergio
A1 Ontañón, Jesús
A1 López-Hoyos, Marcos
A1 Ocejo-Vinyals, Gonzalo
A1 Melero, Josefa
A1 Aguilar, Marta
A1 Almeida, Delia
A1 Medina, Silvia
A1 Vegas, María C
A1 Jiménez, Yesenia
A1 Prada, Álvaro
A1 Monzón, David
A1 Boix, Francisco
A1 Cunill, Vanesa
A1 Molina, Juan
K1 ACE2
K1 C-reactive protein
K1 COVID-19
K1 Immunity
K1 Immunosenescence
K1 Interleukin-6
K1 Lymphocytes
K1 Renin-angiotensin system
K1 Severe acute respiratory syndrome coronavirus 2
K1 Spain
AB The SARS-CoV-2 infection has widely spread to become the greatest public health challenge to date, the COVID-19 pandemic. Different fatality rates among countries are probably due to non-standardized records being carried out by local health authorities. The Spanish case-fatality rate is 11.22%, far higher than those reported in Asia or by other European countries. A multicentre retrospective study of demographic, clinical, laboratory and immunological features of 584 Spanish COVID-19 hospitalized patients and their outcomes was performed. The use of renin-angiotensin system blockers was also analysed as a risk factor. In this study, 27.4% of cases presented a mild course, 42.1% a moderate one and for 30.5% of cases, the course was severe. Ages ranged from 18 to 98 (average 63). Almost 60 % (59.8%) of patients were male. Interleukin 6 was higher as severity increased. On the other hand, CD8 lymphocyte count was significantly lower as severity grew and subpopulations CD4, CD8, CD19, and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 lymphocytes was found in males. The use of angiotensin-converting enzyme inhibitors was associated with a better prognosis. The angiotensin II receptor blocker use was associated with a more severe course. Age and age-related comorbidities, such as dyslipidaemia, hypertension or diabetes, determined more frequent severe forms of the disease in this study than in previous literature cohorts. Our cases are older than those so far reported and the clinical course of the disease is found to be impaired by age. Immunosenescence might be therefore a suitable explanation for the hampering of immune system effectors. The adaptive immunity would become exhausted and a strong but ineffective and almost deleterious innate response would account for COVID-19 severity. Angiotensin-converting enzyme inhibitors used by hypertensive patients have a protective effect in regards to COVID-19 severity in our series. Conversely, patients on angiotensin II receptor blockers showed a severer disease.
SN 1742-4933
YR 2020
FD 2020-08-14
LK https://hdl.handle.net/10668/28340
UL https://hdl.handle.net/10668/28340
LA en
DS RISalud
RD Feb 24, 2025