Abstract:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes virus-induced-senescence. There is an association between shorter telomere length (TL) in coronavirus disease 2019 (COVID-19) patients and hospitalization, severity, or even death. However, it remains unknown whether virus-induced-senescence is reversible. We aim to evaluate the dynamics of TL in COVID-19 patients 1 year after recovery from intensive care units (ICU). Longitudinal study enrolling 49 patients admitted to ICU due to COVID-19 (August 2020 to April 2021). Relative telomere length (RTL) quantification was carried out in whole blood by monochromatic multiplex real-time quantitative PCR (MMqPCR) assay at hospitalization (baseline) and 1 year after discharge (1-year visit). The association between RTL and ICU length of stay (LOS), invasive mechanical ventilation (IMV), prone position, and pulmonary fibrosis development at 1-year visit was evaluated. The median age was 60 years, 71.4% were males, median ICU-LOS was 12 days, 73.5% required IMV, and 38.8% required a prone position. Patients with longer ICU-LOS or who required IMV showed greater RTL shortening during follow-up. Patients who required pronation had a greater RTL shortening during follow-up. IMV patients who developed pulmonary fibrosis showed greater RTL reduction and shorter RTL at the 1-year visit. Patients with longer ICU-LOS and those who required IMV had a shorter RTL in peripheral blood, as observed 1 year after hospital discharge. Additionally, patients who required IMV and developed pulmonary fibrosis had greater telomere shortening, showing shorter telomeres at the 1-year visit. These patients may be more prone to develop cellular senescence and lung-related complications; therefore, closer monitoring may be needed.
摘要:
严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)引起病毒诱导的衰老。2019年冠状病毒病(COVID-19)患者的端粒长度(TL)较短与住院之间存在关联,严重程度,甚至死亡。然而,目前尚不清楚病毒诱导的衰老是否可逆。我们的目的是评估重症监护病房(ICU)康复1年后COVID-19患者的TL动态。纵向研究纳入49例因COVID-19入院的ICU患者(2020年8月至2021年4月)。在住院时(基线)和出院后1年(1年随访),通过单色多重定量PCR(MMqPCR)测定对全血中的相对端粒长度(RTL)进行定量。RTL与ICU住院时间(LOS)之间的关联,有创机械通气(IMV),俯卧位,评估1年访视时肺纤维化的发展。中位年龄为60岁,71.4%为男性,中位ICU-LOS为12天,73.5%要求IMV,38.8%的人需要俯卧位。ICU-LOS较长或需要IMV的患者在随访期间显示出更大的RTL缩短。需要内旋的患者在随访期间有更大的RTL缩短。发生肺纤维化的IMV患者在1年访视时显示出更大的RTL降低和更短的RTL。ICU-LOS较长的患者和需要IMV的患者外周血RTL较短,出院后1年观察。此外,需要IMV并发展为肺纤维化的患者端粒缩短更大,在1年的访问中显示较短的端粒。这些患者可能更容易发生细胞衰老和肺部相关并发症;因此,可能需要更密切的监测。