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For about
three months now, the world has been struggling to respond to the
rapid spread of the novel coronavirus, also known as COVID-19, now
designated a pandemic by the World Health Organization. As has been
reported widely in the media, the elderly appear to be more
vulnerable to the virus than younger people, and elderly men are the
most vulnerable. Although, the latest statics differ from this
observation. Imperial College London, published a study on March 30,
noted that among people who were infected with the virus, those in
their 70s and 80s had higher mortality rate, and also, they are more
likely to require hospitalization.
Researchers
have been busy trying to figure out what exactly it is that makes the
elderly more vulnerable to COVID-19, with fatal results. This will
help governments and medical professionals to reduce the number of
deaths among the elderly before the virus is brought under control.
Researchers have found that COVID-19 patients, both elderly and
young, are more likely to succumb to COVID-19 if they have
“pre-existing conditions”—that is, one or more chronic illnesses that
the person had before being infected with COVID-19. Thus, age is not
the most important factor in determining who gets ill from the virus.
For example, a healthy 80-year-old may be more successful at fighting
off the infection than a 60-year-old who has diabetes or heart
disease.
The main
reason that a person of any age is more likely to have difficulty
fighting off the virus is compromised immune system. We know that the
human immune system begins to weaken very early on and experiences
the onset of a sharp decline by about age 40. The immune system has
two lines of defense in dealing with any infection. The first is a
general rapid-response mounted by cells known as leukocytes, which go
into action within minutes or hours after the virus (or other
infectious agent) enters the body. Several days later, the second
line of defense takes over in the form of antibodies and T cells,
which target the specific type of virus (or infectious agent).
The problem
is that this second line of defense weakens more rapidly than the
first. By puberty, the body is producing ten times fewer T cells than
it did at birth, and by about age 40, there is another tenfold drop
in the production of T cells. T cells have a “memory” in the sense
that they can recognize a virus that they have encountered before and
can get rid of it more efficiently. With a new virus, such as
COVID-19, the T cells need to figure out how to get rid of it, but older
people have fewer T cells to do this job. Also, as we get older, the
B cells, which produce antibodies, become less efficient at producing
antibodies to fight the infection. Another problem is, the
communication between the two lines of defense slows down, so the
second line of defense is slower to take over the job of fighting the
infection. This means that the leukocytes from the first line of
defense keep doing their job longer than they normally would, with
the result that the body becomes flooded with inflammatory substances
known as cytokines, produced by the leukocytes. An excess of
cytokines in the body causes severe breathing problems, which is one
of the major causes of death among those infected with COVID-19. A
study by the Jackson Laboratory for Genomic Medicine, published in
February, found that older men have a more robust first line of
defense, with more cytokine-producing cells, while older women have
more numerous and more efficient B cells and T cells. This may
explain why older men have been more adversely affected than older
women by COVID-19.
In this time
of crisis our elderly loved ones must follow and should be assisted
to follow all the guidelines and precautions issued by the local,
state and federal health authorities.
Warmly,
Veena J. Alfred, PhD., Certified Dementia Practitioner
CEO/Administrator
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