Abstract Number: PB1295
Meeting: ISTH 2022 Congress
Background: The COVID-19 pandemic highlighted the vulnerability of the elderly population towards infectious threats, illustrating that aging is accompanied by dysregulated immune responses summarised in terms like inflammaging, immunoparalysis and immunothrombosis.
Aims: To gain a better understanding on the underlying mechanisms of the age-associated risk of adverse outcome in individuals experiencing a SARS-CoV-2 infection, we analysed the impact of age on circulating monocyte phenotypes, activation markers, inflammatory cytokines, haemostatic parameters and the onset of anti-SARS-CoV-2 antibody production in the context of COVID-19 disease progression and outcome.
Methods: Blood samples were collected at the day of hospital admission followed by repeated blood draws (EK1315/2020). Blood parameters were quantified by bead-based immunoassays and flow cytometry. Mixed linear models were applied to explore if the cytokine levels, monocyte subset ratios and antibody titers develop differently over the disease course in younger and elderly COVID-19 patients and whether this development in turn differs between the outcome groups.
Results: Our data indicate no age-associated differences in monocyte subset composition. However, age and outcome are associated with differences in monocyte activation status. Moreover, a distinct cytokine pattern of IL-6, IL-8 and TNF in elderly survivors versus non-survivors suggests that older patients with adverse outcome experience an inappropriate immune response. Anti- spike S1 IgGs are reduced in elderly. However, deceased patients had higher anti-spike IgG levels than patients requiring intensive care indicating that antibodies are not necessarily protective against adverse outcome. In addition, strong correlations were found between anti-spike S1-, anti-nucleocapsid and anti-RBD IgGs and platelet counts implying that platelets may play an underestimated role in the production of anti-SARS-CoV-2 antibodies.
Conclusion(s): Our study underscores the importance of longitudinal monitoring in elderly COVID-19 patients, as dynamic changes after symptom onset can be observed, which allow for a differentiated insight into confounding factors that impact the complex pathogenesis following an infection with SARS-CoV-2.
To cite this abstract in AMA style:Pirabe A, Heber S, Schrottmaier W, Schmuckenschlager A, Treiber S, Pereyra D, Santol J, Pawelka E, Traugott M, Schörgenhofer C, Seitz T, Karolyi M, Jilma B, Resch U, Zoufaly A, Assinger A. Age related differences in monocyte subsets, cytokine patterns and the production of anti-SARS-CoV-2 antibodies during acute COVID-19 – a prospective observational longitudinal study [abstract]. https://abstracts.isth.org/abstract/age-related-differences-in-monocyte-subsets-cytokine-patterns-and-the-production-of-anti-sars-cov-2-antibodies-during-acute-covid-19-a-prospective-observational-longitudinal-study/. Accessed February 21, 2024.
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