How can Biology of Aging Explain the Severity of COVID-19 in Older Adults

In conclusion, increasing age represents an unquestionable risk factor for poor outcomes in COVID-19 infection. Common features of older people, such as increased incidence of comorbidities, dysregulation of immune system, and malnutrition, interplay with ultrastructural changes of aged systems (mainly the respiratory one) in exacerbating inflammatory deleterious pathways triggered by SARS-CoV-2 virus. In this context, ACE2 role is deserving a lot of interest as key mechanism involved in pathogenesis and evolution of disease, although data on the older subgroups are scarce and mostly theoretic. Further and more specific studies should be encouraged to better understand all these mechanisms, in order to achieve targeted approaches and, hopefully, preventive strategies in frail subjects, such as the elderly.