A Geroscience Perspective on COVID-19 Mortality

Abstract

A novel coronavirus, SARS-CoV-2, emerged in December 2019, leading within a few months to a global pandemic. COVID-19, the disease caused by this highly contagious virus, can have serious health consequences, though risks of complications are highly age-dependent. Rates of hospitalization and death are less than 0.1% in children, but increase to 10% or more in older people. Moreover, at all ages, men are more likely than women to suffer serious consequences from COVID-19. These patterns are familiar to the geroscience community. The effects of age and sex on mortality rates from COVID-19 mirror the effects of aging on almost all major causes of mortality. These similarities are explored here, and underscore the need to consider the role of basic biological mechanisms of aging on potential treatment and outcomes of COVID-19.

Keywords: Biology of aging; COVID-19; Immunosenescence; Mortality; SARS-CoV-2.

Figure 1.

Age-related risk of death from COVID-19. (A) Case fatality rate for COVID-19 in China and Italy, plotted on an absolute scale. (B) Case fatality rate for COVID-19 in China and Italy, plotted on a log₁₀ scale. Straight lines represent fitted values from least-squares fitted regression from ages 20–70. (C) Deaths per 100,000 from COVID-19 in New York City plotted on an absolute scale. (D) Deaths per 100,000 from COVID-19 in New York City plotted on a log₁₀ scale. The straight line is the fitted linear regression.

Figure 2.

Age-related risk of mortality from multiple causes. (A) Deaths per 100,000 from specific causes, as well as all-cause mortality, for both sexes in the United States, 2017. (B) Deaths per 100,000 from specific causes and all-cause mortality, plotted on a log₁₀ scale. The numbers in the legend refer to the mortality rate doubling time (MRDT). The dotted line is deaths per 100,000 from COVID-19 in New York City. The New York City MRDT = 9.0 years (95% confidence interval [CI] = 6.6–13.9). For specific causes of mortality, MRDT 95% CI: all causes (8.6–9.1); heart disease (6.4–7.6); malignant neoplasms (5.7–7.0); Chronic obstructive pulmonary disease (COPD) (4.5–5.0); diabetes (6.7–7.5); and kidney disease (6.4–6.7).

Figure 3.

Sex-differences in age-related mortality. (A) Age-specific deaths per 100,000 population in the United States in 2017 for males (blue) and females (red). (B) Age-specific case fatality rate for COVID-19 for men (blue) and women (red) in Italy in 2020.