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The length of the protective ‘hoods’ at the end of chromosomes (DNA), the telomeres, can determine the risk of death from Covid in women. It has been seen by research carried out at the Carlos III Health Institute that is being presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), which suggests that shorter telomeres, a characteristic of aging, can influence the severity of Covid-19 and the risk of dying from the disease, especially in women.
«We have observed that the shortening of telomeres, especially in women over 65 years of age, has an effect on the risk of death, increasing it», assure Ana Virseda-Berdices, Amanda Fernández-Rodríguez and M.
Ángeles Jiménez-Sousa, authors of the work.
“Our findings show the role of telomere length in Covid-19 mortality and highlight its potential as a predictor of death and serious outcome, particularly in older women,” says Virseda Berdices.
“We consider -they say- that it could be a useful marker in the clinic”.
Telomeres shorten throughout life. Its length is often used as a measure of cell age. Shorter telomeres are associated with a number of age-related diseases, including cancer and osteoarthritis, as well as an increased risk of developing infections.
In addition to aging, explains Virseda Berdices, “telomere dysfunction is also associated with smoking, poor diet, higher body mass index, and other factors that promote oxidative stress, chronic inflammation, and cancer.”
Given the importance of telomere length in cellular health and aging, understanding telomere dynamics in Covid-19 infection is critical.
The authors assure that the length of the telomere has been studied in different diseases, such as cardiovascular -coronary heart disease or atherosclerosis-, type II diabetes, stroke, and also with a higher risk of infections, and some research has seen «an association between shorter telomere length and increased risk of hospitalization due to infection».
In this study, the association between the relative length of the telomeres (RTL) at the beginning of the disease and mortality from Covid-19 in 608 adults hospitalized with Covid-19 during the first wave of the pandemic (March to September 2020).
Blood samples were collected within 20 days of Covid-19 diagnosis or hospitalization. In addition, genetic analysis with PCR was performed to measure the length of telomeres in blood cells.
There are several techniques to measure telomeres, he explains, and PCR, today, “is within the reach of any hospital.”
The researchers calculated survival probabilities and used models to explore the association between relative telomere length and mortality, taking into account patient characteristics such as age, gender, smoking, and associated conditions.
Of the patients included in the investigation, 533 survived (mean age 67 years, 58% men, 73% white, 24% Hispanic) and 75 died from Covid-19 (mean age 78 years, 67% men, 77% white and 21% Hispanic).
The analyzes found that in all patients, relative telomere length was significantly inversely associated with death from Covid-19 at 30 and 90 days after hospital discharge. In other words, they explain, it means that having shorter telomeres is associated with an increased risk of death and longer telomeres with a reduction in said risk of death.
When the data was analyzed by age and gender, the researchers found that having a longer relative telomere length was associated with a 70% lower risk of dying from Covid-19 in all women at 30 days, and 76% at 90 days.
Similarly, the study shows that in women over the age of 65, longer relative telomere length was associated with a 78% lower risk of death from Covid-19 at 30 days and an 81% lower risk at 90 days.
Nevertheless, no significant differences were found in the relative length of telomeres between men who survived Covid-19 and those who died from the disease.
The authors acknowledge that this is an observational study and does not prove cause and effect and that, furthermore, it was carried out during the first wave of the pandemic, which may limit the conclusions that can be drawn.
In any case, Virseda Berdices points out, although we do not know the reasons for the strong association found in women, “it is possible that the absence of association between the length of telomeres and mortality from Covid-19 in men is due to the increase in comorbidities and risk factors in these that masked the effect.
Because, he adds, patients tend to have less severe disease and, therefore, “more likely to survive ovid-19, probably due to fewer risk factors and lifestyle comorbidities than men.”
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