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 Severe acute respiratory syndrome coronavirus 2 K1 COVID-19 K1 Immunosenescence K1 Immunity K1 Renin-angiotensin system K1 ACE2 K1 Interleukin-6 K1 C-reactive protein K1 Lymphocytes K1 Spain K1 Betacoronavirus K1 Inmunosenescencia K1 Inmunidad K1 Sistema renina-angiotensina K1 Interleucina-6 K1 Proteína C-Reactiva K1 Linfocitos K1 Angiotensin converting enzyme 2 AB Background: 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.Results: 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.Conclusions: 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. PB BioMed Central YR 2020 FD 2020-08-14 LK http://hdl.handle.net/10668/3280 UL http://hdl.handle.net/10668/3280 LA en NO Jurado A, Martín MC, Abad-Molina C, Orduña A, Martínez A, Ocaña E, et al. COVID-19: age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study. Immun Ageing. 2020 Aug 14;17:22. DS RISalud RD Apr 12, 2025