Preprint Concept Paper Version 1 Preserved in Portico This version is not peer-reviewed

How studies on inflamm-aging may help to understand and combat COVID-19 pandemic.

Version 1 : Received: 7 April 2020 / Approved: 9 April 2020 / Online: 9 April 2020 (14:43:41 CEST)

How to cite: Storci, G.; Bonifazi, F.; Garagnani, P.; Olivieri, F.; Bonafe, M. How studies on inflamm-aging may help to understand and combat COVID-19 pandemic.. Preprints 2020, 2020040158 (doi: 10.20944/preprints202004.0158.v1). Storci, G.; Bonifazi, F.; Garagnani, P.; Olivieri, F.; Bonafe, M. How studies on inflamm-aging may help to understand and combat COVID-19 pandemic.. Preprints 2020, 2020040158 (doi: 10.20944/preprints202004.0158.v1).

Abstract

More than 1,000,000 confirmed cases of COVID-19 have been registered worldwide since the beginning of the pandemic in Wuhan on December 2019. The high mortality rate of COVID-19 is associated with age, gender and the presence of comorbidities. Biochemical data have shown that COVID-19 patients develop a local and systemic hyper-inflammatory response associated with poor outcome. Therefore, the understanding of the biological mechanisms underlying SARS-CoV-2-induced inflammation is a compelling need. Following this reasoning, here we will focus on the importance of the progressive age-related development of a pro-inflammatory state (aka inflamm-aging) in the understanding of the unbalanced inflammatory response against SARS-CoV-2 in aged people. In particular, we underpin the role of mitochondrial DNA and genomic DNA telomeric sequences in local and systemic mechanisms of inflammation. Indeed, the leakage of mtDNA out of its natural compartment (i.e. the mitochondrion), into the cytoplasm and in the extracellular environment is a powerful trigger of innate immunity and inflammation, as part of an evolutionary-conserved signaling mechanism of cellular damage (e.g. viral infection). High levels of circulating mtDNA are increased in aged people and set up as inflammatory markers of poor prognosis in intensive care unit patients. In turn, telomeric DNA, which can be released into the cytoplasm and in the extracellular environment upon cell damage, has been proven to exert potent anti-inflammatory activity. Since that aged people (particularly those affected by co-morbidity) are equipped with shortened telomeres, we posit that, in aged people affected by COVID-19 the release of mtDNA, coupled with insufficient telomeric DNA favors the onset of a detrimental inflammatory response. In this regard, we highlight that the mechanism of action of some currently used drugs, as well as potential new ones may be better understood under the light of the above-depicted theoretical framework thus explaining how studies on inflamm-aging may help to understand and combat COVID-19 pandemic.

Subject Areas

Covid-19; SARS-CoV-2; Inflamm-aging; mtDNA; Telomere; Inflammation

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