Age-dependent virulence of human pathogens

PLoS Pathog. 2022 Sep 22;18(9):e1010866. doi: 10.1371/journal.ppat.1010866. eCollection 2022 Sep.

Abstract

Host age is often evoked as an intrinsic factor aggravating the outcome of host-pathogen interactions. However, the shape of the relationship between age and infection-induced mortality might differ among pathogens, with specific clinical and ecological traits making some pathogens more likely to exert higher mortality in older hosts. Here, we used a large dataset on age-specific case fatality rate (CFR) of 28 human infectious diseases to investigate i) whether age is consistently associated to increased CFR, ii) whether pathogen characteristics might explain higher CFR in older adults. We found that, for most of the infectious diseases considered here, CFR slightly decreased during the first years of life and then steeply increased in older adults. Pathogens inducing diseases with long-lasting symptoms had the steepest increase of age-dependent CFR. Similarly, bacterial diseases and emerging viruses were associated with increasing mortality risk in the oldest age classes. On the contrary, we did not find evidence suggesting that systemic infections have steeper slopes between CFR and age; similarly, the relationship between age and CFR did not differ according to the pathogen transmission mode. Overall, our analysis shows that age is a key trait affecting infection-induced mortality rate in humans, and that the extent of the aggravating effect on older adults depends on some key traits, such as the duration of illness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Communicable Diseases*
  • Host-Pathogen Interactions
  • Humans
  • Intrinsic Factor
  • Virulence
  • Viruses*

Substances

  • Intrinsic Factor

Grants and funding

GS acknowledges support under grant number ANR-21-CE35-0015 from the Agence Nationale de la Recherche, https://anr.fr/. The funder had no role in study design data collection, and analysis, decision to publish or preparation of the manuscript.