Evaluation of the alterations in the immune/inflammatory response in the nasopharyngeal mucosa in elderly patients co-infected by SARS-CoV-2 and Cytomegalovirus

Abstract

Currently, the world is facing a pandemic caused by the new coronavirus SARS- CoV-2, which causes the disease named "coronavirus disease-2019" or COVID-19. It has been documented that the elderly are not only the most affected population, but also account for the highest number of deaths in COVID-19. Studies suggest that the increase in the rate of infection, severity, and lethality by SARS-CoV-2 in the elderly is associated with both the occurrence of immunosenescence and the "inflammaging" phenomenon. Whereas the immunosenescence indicates a prominent decline in systemic and mucosal immune responses, especially in the airways, associated with aging, "inflammaging" represents a chronic and systemic low-grade inflammatory state associated with aging. Particularly in this sense, it has been proposed that the reactivation of the infection by cytomegalovirus (CMV), a herpes virus, can favor the development of immunosenescence since it can be an important triggering factor of "inflammaging". Based on these pieces of information, this study aims to investigate the impact of co-infection by SARS-CoV-2 and CMV on immune/inflammatory responses in the upper airway in elderly individuals. One-hundred and twenty (120) elderly people of both sexes, aged between 60 and 85 years presenting or not infection by SARS-CoV-2 and CMV will be invited to participate in this study. Samples of nasopharyngeal swab will be obtained in two different occasions (acute phase of the disease and in cure phase) from different groups of elderly volunteers: 30 samples from patients with mild symptoms; 30 samples from patients with moderate symptoms; 30 samples from patients with severe symptoms of the COVID-19 and 30 samples from elderly individuals without the manifestation of respiratory symptoms and with a negative diagnosis for COVID-19 and CMV. These samples will be used: 1) to confirm the presence of SARS-CoV-2 and CMV infections; 2) to determine the concentrations of immunoglobulins A, M, and G specific for SARS-CoV-2, antimicrobial peptides, and cytokines.