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Could Immune System Boosters Make COVID-19 Less Dangerous for the Elderly?

Concerned that even when effective treatment and vaccines become available to combat the novel coronavirus causing the current pandemic, those are likely to be less effective in older adults, a UK research foundation is suggesting more research on medications that can strengthen the immune system in the elderly. Find out what products they suggest for study and why that could make a difference in how infections such as COVID-19 sicken those 60 and older.

LONDON – By this point, it is well known that the SARS-CoV-2 betacoronavirus responsible for the COVID-19 pandemic is especially dangerous for older adults.

In fact, a recent article suggests that COVID-19 should be referred to as a gerolavic --from Greek, géros "old man" and epilavís, "harmful" -- infection because the infection rates, severity, and lethality are substantially higher in the population aged 60 and older.

“This is primarily due to comorbidity but may be partially due to immunosenescence, decreased immune function in the elderly, and general loss of function, fitness, and increased frailty associated with aging,” according to an article in the journal Aging. “Immunosenescence is a major factor affecting vaccination response, as well as the severity and lethality of infectious diseases.”

The article from the Biogerontology Research Foundation, a registered UK charity supporting and promoting aging and longevity research worldwide since 2008, cautions that while vaccination reduces infection rates, and therapeutic interventions reduce the severity and lethality of infections, those interventions have limitations, especially in the elderly.

The author suggests that medications that have geroprotective and senoremediative effects be considered for use to help protect older adults from COVID-19.

“Previous studies showed that postulated geroprotectors, such as sirolimus (rapamycin) and its close derivative rapalog everolimus (RAD001), decreased infection rates in a small sample of elderly patients,” the author writes, noting that the article presents a review of the limited literature available on those interventions to decrease the disease burden of infections that are especially danger for older adults.

The article also discusses the need for rigorous clinical validation of measures of aging beyond biological age, which could be used to assess the need for, and efficacy of, geroprotective and senoremediative interventions and provide better protection for elderly populations from gerolavic infections.

The report cautions that the medications discussed are not yet licensed or recommended as immune system boosters, as they have not undergone clinical evaluation for this purpose.

In addition to rapamycin, other possible geroprotectors include nicotinamide riboside, nicotinamide mononucleotide, metformin, and other drugs with the known safety profile for prevention of SARS-CoV-2 infection, according to the author, Alex Zhavoronkov, PhD, the chief scientist of the Biogerontology Research Foundation and the CEO of the artificial intelligence company Insilico Medicine .

"We are pursuing several strategies for drug discovery and repurposing using the latest advances in artificial intelligence integrated into our battle-tested discovery platform,” Zhavoronkov said. “However, it is clear that COVID-19 is a gerophilic and gerolavic disease. It is more severe and lethal in the elderly. Aging research yields insights that may not only help with COVID-19 but may help prevent many other diseases and increase productive longevity and re-ignite the economy.”

"This is the first review highlighting geroprotective strategies that may decrease the disease burden of gerolavic infections such as COVID-19. It presents a case for further research and clinical studies to validate markers of biological age in the context of viral infections,” said Richard Siow, PhD. King’s College London, where Siow was a former vice-dean, is partnering with BGRF and Insilico Medicine to identify mechanisms by which geroprotectors enhance resilience against infections and reduce the severity of symptoms.