背景:尽管众所周知,老年人最容易感染COVID-19,但有关百岁老人易感性的数据却相互矛盾。两项流行病学研究表明,年龄较大的百岁老人(在2020年大流行高峰时年龄>101岁)比其余的百岁老人更具弹性,这表明这种韧性可能与1918年西班牙流感大流行有关。为了深入了解这件事,特别是老年百岁老人对SARS-CoV-2感染的抵抗力是否与他们受到的西班牙流感有关,我们进行了一项回顾性血清学研究.这项研究检查了33位百岁老人的血清样本,涵盖半(年龄>104<110岁,N=7)和超百岁老人(年龄>109岁,N=4),出生于1905年至1922年,对抗SARS-CoV-2和1918年H1N1假型病毒。
结果:回忆和实验室数据表明,SARS-CoV-2感染发生在8位百岁老人身上。感染似乎无症状或轻度,不需要住院治疗,尽管8人中有3人年龄在109至110岁之间。百岁老人感染和/或接种疫苗的抗刺药抗体水平较高,虽然不重要,比作为对照的70岁个体的随机样本产生的样本还要多。所有百岁老人对1918年H1N1病毒的抗体水平明显高于(几乎50倍)在引用的70岁受试者组中观察到的水平,确认在维持免疫记忆的关键作用,从100多年前发生的启动。在大流行爆发之前收集血液的百岁老人表现出针对1918年H1N1病毒的中和抗体,但是所有这些受试者的SARS-CoV-2检测呈阴性。
结论:这项回顾性研究表明,年长的百岁老人对COVID-19具有相当的抵抗力,因为他们能够产生良好水平的中和抗体并经历轻度或无症状的疾病。这可以归因于1918年西班牙流感大流行,除了1918年H1N1病毒和SARS-CoV-2之间存在交叉反应性抗体之外。另一种可能性是这种关联纯粹是暂时的,与1918年以后出生的百岁老人相比,仅与有弹性的百岁老人的高龄相关,因为已知年龄较大的百岁老人对免疫-炎症反应的控制更好.
BACKGROUND: Although it is well known that the older people have been the most susceptible to COVID-19, there are conflicting data on the susceptibility of centenarians. Two epidemiological study have shown that older centenarians (> 101 years old at the time of the 2020 pandemic peak) are more resilient than the remaining centenarians, suggesting that this resilience might be linked to the 1918 Spanish Flu pandemic. To gain insight into this matter, specifically whether the resilience of older centenarians to SARS-CoV-2 infection is linked to the Spanish Flu they had been affected by, we conducted a retrospective serological study. This study examined serum samples from 33 centenarians, encompassing semi- (aged > 104 < 110 years, N = 7) and supercentenarians (aged > 109 years, N = 4), born between 1905 and 1922, against both SARS-CoV-2 and 1918 H1N1 pseudotype virus.
RESULTS: Anamnestic and laboratory data suggest that SARS-CoV-2 infection occurred in 8 centenarians. The infection appeared to have been asymptomatic or mild, and hospitalization was not required, despite 3 out of 8 being between 109 and 110 years old. The levels of anti-spike antibodies in centenarians infected and/or vaccinated were higher, although not significantly, than those produced by a random sample of seventy-year-old individuals used as controls. All centenarians had antibody levels against the 1918 H1N1 virus significantly higher (almost 50 times) than those observed in the quoted group of seventy-year-old subjects, confirming the key role in maintaining immunological memory from a priming that occurred over 100 years ago. Centenarians whose blood was collected prior to the pandemic outbreak demonstrated neutralising antibodies against the 1918 H1N1 virus, but all these subjects tested negative for SARS-CoV-2.
CONCLUSIONS: This retrospective study shows that older centenarians are quite resilient to COVID-19, as they are capable of producing good levels of neutralising antibodies and experiencing mild or asymptomatic disease. This could be attributed to the 1918 Spanish flu pandemic through mechanisms other than the presence of cross-reactive antibodies between the 1918 H1N1 virus and SARS-CoV-2. Another possibility is that the association is purely temporal, solely correlated with the advanced age of resilient centenarians compared to those born after 1918, since older centenarians are known to have better control of immune-inflammatory responses.