4.7 Article

Are Older People Really More Susceptible to SARS-CoV-2?

Journal

AGING AND DISEASE
Volume 13, Issue 5, Pages 1336-1347

Publisher

INT SOC AGING & DISEASE
DOI: 10.14336/AD.2022.0130

Keywords

SARS-CoV-2; COVID-19; older people; infection; age; ACE2; cytokine

Funding

  1. Key Research and Development Program of Shaanxi [2019ZDLSF04-05]
  2. National Natural Science Foundation of China [81974522, 81974584]
  3. Subject Innovation Team of Shaanxi University of Chinese Medicine [2019-YL10]

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Older people are more susceptible to SARS-CoV-2 infection and severe illness due to weakened immune mechanisms and the influence of comorbidities.
Since the outbreak, COVID-19 has spread rapidly across the globe due to its high infectivity and lethality. Age appears to be one of the key factors influencing the status and progression of SARS-CoV-2 infection, as multiple reports indicated that the majority of COVID-19 infections and severe cases are elderly. Most people simply assume that the elderly are more susceptible to SARS-CoV-2 than the young, but the mechanism behind it is still open to question. The older and younger people are at similar risk of infection because their infection process is the same and they must be exposed to the virus first. However, whether they will get sick after exposure to the virus and how their disease progresses depend on their immune mechanisms. In older populations, inflammation and immune aging reduce their ability to resist SARS- CoV-2 infection. Meanwhile, under the influence of comorbidities, ACE2 receptor and various cytokines undergo corresponding changes, thus accelerating the entry, replication, and transmission of SARS-CoV- 2 in the body, promoting disease progression, and leading to severe illness and even death. In addition, the relatively fragile mental state of the elderly can also affect their timely recovery from COVID-19. Therefore, once older people are infected with SARS-CoV- 2, they are more prone to severe illness and death with a poor prognosis, and they should strengthen protection to avoid exposure to the virus.

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