Review Article
Year: 2020 | Month: October | Volume: 10 | Issue: 10 | Pages: 166-175
The Increased Risk of Elderly Population in India in COVID-19 Pandemic
Padmshree Mudgal1, Rashmi Wardhan2
1Assoc. Professor, Department of Biochemistry, Daulat Ram College, University of Delhi, Delhi.
2Assoc. Professor, Department of Biochemistry, Shivaji College, University of Delhi, Delhi.
Corresponding Author: Rashmi Wardhan
ABSTRACT
Increase in life expectancy and decline in mortality rate has resulted in a very fast growth rate of elderly population in India. Poor economic condition, low literacy and poor hygiene make the elderly in India at much higher health risk. Most people above the age of 60 suffer from chronic diseases such as, respiratory diseases, cardiovascular diseases (CVD), diabetes, hypertension, dementia, etc. In addition, impaired Immune system associated with old age makes them more susceptible to various infections. The elderly population in India has been the most vulnerable group in COVID-19 pandemic, contributing to ~ 53% of the reported fatalities due to COVID-19. The SARS-CoV-2 virus interacts with angiotensin-converting enzyme 2 (ACE2) on the host cell surface with its S (spike) glycoprotein and then undergoes endocytosis. Inside the cell, the virus replicates and triggers the release of cytokines which can induce an inflammatory response. Chronic increase in systemic inflammation has been seen in the elderly, which is further aggravated on SARS-CoV-2 virus infection. Patients with chronic respiratory diseases have shown significant increase in ACE-2 expression which may increase viral load in case of COVID-19 infection. COVID-19 patients also show elevation of cardiac troponins (cTnI) which puts CVD predisposed patient at a higher risk. The elderly in our country need extra care to be protected from diseases and proper disease management in case of disease manifestation.
Key words: Elders, COVID-19, ACE2, Immunity, Comorbidity