Older patients affected by COVID-19: investigating the existence of biological phenotypes

Abstract Introduction COVID-19 provides an opportunity to examine biological phenotypes (observable morphological, functional and biological characteristics) in individuals who experience the same acute condition, potentially revealing differences in response to acute external stressors. The aim our...

Full description

Saved in:
Bibliographic Details
Main Authors: Alberto Zucchelli, Marta Parigi, Silvia Giliani, Davide Liborio Vetrano, Daniela Lucente, Emanuele Marzetti, Riccardo Calvani, Giuseppe Bellelli, Alessandra Marengoni
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-024-05473-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850062023650443264
author Alberto Zucchelli
Marta Parigi
Silvia Giliani
Davide Liborio Vetrano
Daniela Lucente
Emanuele Marzetti
Riccardo Calvani
Giuseppe Bellelli
Alessandra Marengoni
author_facet Alberto Zucchelli
Marta Parigi
Silvia Giliani
Davide Liborio Vetrano
Daniela Lucente
Emanuele Marzetti
Riccardo Calvani
Giuseppe Bellelli
Alessandra Marengoni
author_sort Alberto Zucchelli
collection DOAJ
description Abstract Introduction COVID-19 provides an opportunity to examine biological phenotypes (observable morphological, functional and biological characteristics) in individuals who experience the same acute condition, potentially revealing differences in response to acute external stressors. The aim our study was to investigate biological phenotypes in older patients hospitalized for COVID-19, exploiting a panel of aging biomarkers. Methods Data were gathered from the FRACOVID Project, an observational multicenter study, aimed to evaluate the impact of frailty on health-related outcomes in patients 60 + with COVID-19 in Northern Italy. A hierarchical cluster analysis was run using log-transformed and scaled values of TNF-a, IL-1 beta, IL-6, PAI-1, GDF-15, NT-proBNP, and Cystatin C evaluated at admission. Results Eighty-one participants (mean age 75.3 years; 60.5% male) were evaluated. Frailty was identified in 42% of the sample and 27.2% were unable to ambulate outdoors. The mean hospital stay was 24.7 days, with an in-hospital mortality rate of 18.5%. Three biological phenotypes were found: (1) ‘inflammatory’, with high inflammatory biomarkers; (2) ‘organ dysfunction’, characterized by elevated cystatin C and NT-proBNP, and lower inflammatory markers; and (3) ‘unspecific’, with lower NT-proBNP and GDF-15 levels, and intermediate concentrations of other biomarkers. The ’organ dysfunction’ phenotype showed the highest mean age and prevalence of frailty, disability, and chronic diseases. The ‘inflammatory‘ phenotype showed the highest burden of respiratory and systemic signs and symptoms of infection. Conclusion Biological phenotypes might be used to identify different clinical and functional phenotypes in individuals affected by COVID-19.
format Article
id doaj-art-3f748bdb2e6e454d969af2f72b31426c
institution DOAJ
issn 1471-2318
language English
publishDate 2024-11-01
publisher BMC
record_format Article
series BMC Geriatrics
spelling doaj-art-3f748bdb2e6e454d969af2f72b31426c2025-08-20T02:50:02ZengBMCBMC Geriatrics1471-23182024-11-012411910.1186/s12877-024-05473-5Older patients affected by COVID-19: investigating the existence of biological phenotypesAlberto Zucchelli0Marta Parigi1Silvia Giliani2Davide Liborio Vetrano3Daniela Lucente4Emanuele Marzetti5Riccardo Calvani6Giuseppe Bellelli7Alessandra Marengoni8Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm UniversityA. Nocivelli Institute for Molecular Medicine, ASST Spedali CiviliA. Nocivelli Institute for Molecular Medicine, ASST Spedali CiviliAging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm UniversityFondazione “Ospedale e Casa di Riposo Nobile Paolo Richiedei”Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro CuoreDepartment of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro CuoreSchool of Medicine and Surgery, Milano-Bicocca UniversityAging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm UniversityAbstract Introduction COVID-19 provides an opportunity to examine biological phenotypes (observable morphological, functional and biological characteristics) in individuals who experience the same acute condition, potentially revealing differences in response to acute external stressors. The aim our study was to investigate biological phenotypes in older patients hospitalized for COVID-19, exploiting a panel of aging biomarkers. Methods Data were gathered from the FRACOVID Project, an observational multicenter study, aimed to evaluate the impact of frailty on health-related outcomes in patients 60 + with COVID-19 in Northern Italy. A hierarchical cluster analysis was run using log-transformed and scaled values of TNF-a, IL-1 beta, IL-6, PAI-1, GDF-15, NT-proBNP, and Cystatin C evaluated at admission. Results Eighty-one participants (mean age 75.3 years; 60.5% male) were evaluated. Frailty was identified in 42% of the sample and 27.2% were unable to ambulate outdoors. The mean hospital stay was 24.7 days, with an in-hospital mortality rate of 18.5%. Three biological phenotypes were found: (1) ‘inflammatory’, with high inflammatory biomarkers; (2) ‘organ dysfunction’, characterized by elevated cystatin C and NT-proBNP, and lower inflammatory markers; and (3) ‘unspecific’, with lower NT-proBNP and GDF-15 levels, and intermediate concentrations of other biomarkers. The ’organ dysfunction’ phenotype showed the highest mean age and prevalence of frailty, disability, and chronic diseases. The ‘inflammatory‘ phenotype showed the highest burden of respiratory and systemic signs and symptoms of infection. Conclusion Biological phenotypes might be used to identify different clinical and functional phenotypes in individuals affected by COVID-19.https://doi.org/10.1186/s12877-024-05473-5BiomarkersCOVID-19ElderlyFrailty
spellingShingle Alberto Zucchelli
Marta Parigi
Silvia Giliani
Davide Liborio Vetrano
Daniela Lucente
Emanuele Marzetti
Riccardo Calvani
Giuseppe Bellelli
Alessandra Marengoni
Older patients affected by COVID-19: investigating the existence of biological phenotypes
BMC Geriatrics
Biomarkers
COVID-19
Elderly
Frailty
title Older patients affected by COVID-19: investigating the existence of biological phenotypes
title_full Older patients affected by COVID-19: investigating the existence of biological phenotypes
title_fullStr Older patients affected by COVID-19: investigating the existence of biological phenotypes
title_full_unstemmed Older patients affected by COVID-19: investigating the existence of biological phenotypes
title_short Older patients affected by COVID-19: investigating the existence of biological phenotypes
title_sort older patients affected by covid 19 investigating the existence of biological phenotypes
topic Biomarkers
COVID-19
Elderly
Frailty
url https://doi.org/10.1186/s12877-024-05473-5
work_keys_str_mv AT albertozucchelli olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT martaparigi olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT silviagiliani olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT davideliboriovetrano olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT danielalucente olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT emanuelemarzetti olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT riccardocalvani olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT giuseppebellelli olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes
AT alessandramarengoni olderpatientsaffectedbycovid19investigatingtheexistenceofbiologicalphenotypes