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<div class="story-highlights">
<p id="expanderHead" data-jsid="expanderHead">I pasted the whole
article because of the problems Dr. Mercola is having with
censorship on the Internet.<br>
</p>
<h1 class="seo-highlighter"><span id="bcr_lblSubject">Why COVID-19
Disproportionately Affects the Elderly</span></h1>
<h3 id="expanderHead" data-jsid="expanderHead">Story at-a-glance </h3>
<div id="expanderContent" data-jsid="expanderContent">
<ul>
<li>
<span id="bcr_rptStory_cslStory_0">While the mortality rate
for COVID-19 varies around the world, one trend is clear:
The infection disproportionately affects the elderly, with
those over the age of 75 making up the bulk of the deaths</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_1">Adults over 65 years of
age represent 80% of hospitalizations and have a 23-fold
greater risk of death than those under 65</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_2">In addition to age,
underlying health conditions are primary risk factors that
raise your risk of death from COVID-19</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_3">More than 80% of deaths
have occurred in nursing homes, assisted living facilities
and live-in rehab centers. More than 90% of such residents
have at least one chronic disease and more than 70% have
two conditions</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_4">Additional factors that
make the elderly more susceptible to dying is an aging
immune system, excessive calorie intake and epigenetic
changes that occur with age, specifically the
dysregulation of the epigenome and changes in
glycosylation</span>
</li>
</ul>
</div>
</div>
<div class="bodytextdiv" id="bodytext">
<span id="bcr_FormattedBody">
<p>While the mortality rate for COVID-19<sup style="font-size:
10px;"><span id="edn1" data-hash="#ednref1">1</span></sup>
varies around the world (in large part due to variations in
testing), one trend is clear: The infection disproportionately
affects the elderly, with those over the age of 75 making up
the bulk of the deaths.</p>
<h2>COVID-19 Outcomes Tied to Age </h2>
<p>Looking at provisional data<sup style="font-size: 10px;"><span
id="edn2" data-hash="#ednref2">2</span></sup> from the
U.S. Centers for Disease Control and Prevention, you can see a
clear and dramatic increase in deaths for each older age
group. </p>
<p>For young people, especially children, the risk of death is
negligible. (Even so, more elderly die from pneumonia that is
unrelated to COVID-19. The statistics separate out COVID-19
cases, pneumonia only, and pneumonia with concurrent COVID-19
infection.<sup style="font-size: 10px;"><span id="edn3"
data-hash="#ednref3">3</span></sup>) </p>
<p>The exact same age-dependent trend is seen in other
countries, four examples of which are included in the
OurWorldInData.org’s graph below.<sup style="font-size: 10px;"><span
id="edn4" data-hash="#ednref4">4</span></sup> As noted in
a May 29, 2020, review<sup style="font-size: 10px;"><span
id="edn5" data-hash="#ednref5">5</span></sup> in the
journal Aging, “Adults over 65 years of age represent 80% of
hospitalizations and have a 23-fold greater risk of death than
those under 65.”</p>
<figure class="center-img">
<img style="max-width:700px;width:100%!important;"
alt="coronavirus case fatality by age" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/coronavirus-case-fatality-by-age.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/coronavirus-case-fatality-by-age.jpg">
</figure>
<p>Below is a graph created by the Minnesota Department of
Health, published by Twin Cities Pioneer Press<sup
style="font-size: 10px;"><span id="edn6"
data-hash="#ednref6">6</span></sup> June 1, 2020, showing
the same kind of age-dependent mortality curve.</p>
<figure class="center-img">
<img style="max-width:600px;width:100%!important;"
alt="minnesota covid 19 deaths by age group" class="
ls-is-cached mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/minnesota-covid-19-deaths-by-age-group.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/minnesota-covid-19-deaths-by-age-group.jpg">
</figure>
<h2> Underlying Conditions Are a Primary Risk Factor</h2>
<p>In addition to age, underlying health conditions (so-called
comorbidities) are a primary risk factor that raises your risk
of death from COVID-19. Not surprisingly, the elderly tend to
have more underlying conditions. Very few people who have no
underlying health conditions at all end up dying from this
infection.</p>
<p>Below is an Our World in Data graph showing the breakdown of
comorbidities found in Chinese patients, as of February 11,
2020.<sup style="font-size: 10px;"><span id="edn7"
data-hash="#ednref7">7</span></sup></p>
<figure class="center-img">
<img style="max-width:600px;width:100%!important;"
alt="coronavirus early stage" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/coronavirus-early-stage.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/coronavirus-early-stage.jpg">
</figure>
<p>Another graph from the Minnesota Department of Health,
(again, published by Twin Cities Pioneer Press<sup
style="font-size: 10px;"><span id="edn8"
data-hash="#ednref8">8</span></sup>) reveals a different
picture of prevailing comorbidities, yet the trend itself is
clear: A vast majority of those who die have underlying
conditions that make them more susceptible to severe infection
and death. </p>
<figure class="center-img">
<img style="max-width:600px;width:100%!important;" alt="pre
existing conditions fatal coronavirus" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/pre-existing-conditions-fatal-coronavirus.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/pre-existing-conditions-fatal-coronavirus.jpg">
</figure>
<p>In the case of Minnesota, 97% of COVID-19-related deaths have
occurred in those “already fighting serious illness before
they were infected.“<sup style="font-size: 10px;"><span
id="edn9" data-hash="#ednref9">9</span></sup> The average
age of those who have died is 82. Meanwhile, the medial age of
Minnesotans with known COVID-19 infection is 42.</p>
<p>Just like in other areas, more than 80% of <a
href="https://articles.mercola.com/sites/articles/archive/2020/05/07/nursing-homes-covid-19-risks.aspx">deaths
occurred in nursing homes</a>, assisted living facilities
and live-in rehab centers, and there are logical reasons for
this. More than 90% of residents of these centers have at
least one chronic disease and more than 70% have two
conditions, which in turn can weaken their immune systems.<sup
style="font-size: 10px;"><span id="edn10"
data-hash="#ednref10">10</span></sup> They also live in
close quarters and share staff, which facilitates the spread
of pathogens. </p>
<p>Italy and certain states in the U.S. — most notably New York,
which has the highest COVID-19 death rate in the world — made
the grave error of sending COVID-19 infected patients into
nursing homes. </p>
<p>In light of what we currently know about the transmission,
this was one of the most catastrophic and negligent government
decisions that likely caused far more deaths than the lockdown
prevented.</p>
<p>Rather than calling for the total lockdown of healthy and
low-risk populations, why did health and government officials
not simply call for the protection and isolation of the
elderly?</p>
<aside class="takeaway tamiddle">
<p>Nursing home residents and workers account for about
one-third of all COVID-19 deaths in the U.S., and up to 20%
of hospitalized COVID-19 patients actually caught it in the
hospital while being treated for another ailment.</p>
</aside>
<p>According to a May 15, 2020, report by the University of
Michigan,<sup style="font-size: 10px;"><span id="edn11"
data-hash="#ednref11">11</span></sup> nursing home
residents and workers account for about one-third of all
COVID-19 deaths in the U.S. Another report<sup
style="font-size: 10px;"><span id="edn12"
data-hash="#ednref12">12</span></sup> in The Guardian has
pointed out that up to 20% of hospitalized COVID-19 patients
actually caught it in the hospital while being treated for
another ailment. </p>
<p>If 20% of people catch the disease at the hospital and 33% of
deaths happen in nursing homes, just how much of the entire
disease burden is a result of the health care system alone?</p>
<div class="productad">
<div class="label"><span>Advertisement</span></div>
<hr></div>
<h2>Biological Differences Help Explain Age-Related Morbidity</h2>
<p>According to the outstanding May 29, 2020, review by David
Sinclair on the molecular biology of COVID-19<sup
style="font-size: 10px;"><span id="edn13"
data-hash="#ednref13">13</span></sup> mentioned earlier,
“Comorbidities such as cardiovascular disease, diabetes and
obesity increase the chances of fatal disease, but they alone
do not explain why age is an independent risk factor.” </p>
<p>If that’s so, then what else might account for the radical
discrepancy in mortality? In his excellent review, Sinclair
discusses the “molecular differences between young,
middle-aged and older people that may explain why COVID-19 is
a mild illness in some but life-threatening in others.” If you
have any interest in this topic I would strongly recommend
reading this paper.</p>
<p>Importantly, Sinclair points out that inhibiting the virus is
not enough in and of itself. One must also restore the
patient’s ability to fight the infection and upregulate their
immune responses to avoid an overreaction. This is done by
many strategies I have previously discussed such as exercise,
time-restricted eating and <a
href="https://articles.mercola.com/sites/articles/archive/2019/10/20/regenerative-medicine-benefits.aspx">NAD+
optimization</a>.</p>
<h2>The Aging Immune System</h2>
<p>Topping the list of additional factors that make the elderly
more susceptible to dying is an aging immune system — both the
innate and adaptive arms. As noted by Sinclair:<sup
style="font-size: 10px;"><span id="edn14"
data-hash="#ednref14">14</span></sup></p>
<blockquote>
<p><em>“For the immune system to effectively suppress then
eliminate SARS-CoV-2, it must perform four main tasks: 1)
recognize, 2) alert, 3) destroy and 4) clear. Each of
these mechanisms are known to be dysfunctional and
increasingly heterogeneous in older people.” </em> </p>
</blockquote>
<p>During aging, your immune system undergoes a gradual decline
in function known as immunosenescence, which inhibits your
body’s ability to recognize, alert and clear pathogens. Aging
also increases systemic inflammation, known as inflammaging,
thanks to an overactive yet ineffective alert system.
According to Sinclair:</p>
<blockquote>
<p>“<em>An abundance of recent data describing the pathology
and molecular changes in COVID-19 patients points to both
immunosenescence and inflammaging as major drivers of the
high mortality rates in older patients.</em></p>
</blockquote>
<blockquote>
<p><em>The inability of [alveolar macrophages] AMs in older
individuals to recognize viral particles and convert to a
pro-inflammatory state likely accelerates COVID-19 in its
early stages, whereas in its advanced stages, AMs are
likely to be responsible for the excessive lung damage.”</em></p>
</blockquote>
<p>Sinclair also addresses the impact an aging innate immune
system has on vaccination efficacy, noting that: </p>
<blockquote>
<p><em>“In the aged, immune responses to vaccination are also
often weak or defective whereas autoimmunity increases.
Therefore, in designing vaccines against SARS-CoV-2, it
will be important to consider that older people may not
respond as well to vaccines as young people.”</em></p>
</blockquote>
<h2>Vascular Inflammation Is a Risk Factor</h2>
<p>While we have all heard of the cytokine storm, what is even
more predictive of death is an increase in the fibrin
degradation product D-dimer that is released from blood clots
in the microvasculature and is highly predictive of
disseminated intravascular coagulation (DIC). The elderly have
naturally higher levels of D-dimer, which appears to be a “key
indicator for the severity of late-stage COVID-19,” the
Sinclair states.<sup style="font-size: 10px;"><span id="edn15"
data-hash="#ednref15">15</span></sup></p>
<p>In the elderly, elevated levels are thought to be due to
higher basal levels of vascular inflammation associated with
cardiovascular disease, and this, the authors say, “could
predispose patients to severe COVID-19.” Similarly, the
elderly tend to have higher levels of NLRP3 inflammasomes,
which appear to be a key culprit involved in cytokine storms.
According to Sinclair:</p>
<blockquote>
<p><em>“In older individuals, NLRP3 may be poised for
hyperactivation by SARS-CoV-2 antigens. NLRP3 activity is
under the direct control of sirtuin 2 (SIRT2), a member of
the NAD+-dependent sirtuin family of deacetylases. </em></p>
</blockquote>
<blockquote>
<p><em>During aging, NAD+ levels decline, reducing the
activity of the sirtuins. Old mice … have decreased
glucose tolerance and increased insulin resistance. This
decline, exacerbated by COVID-19, might promote
hyperactivation of NLRP3 and the trigger [for] cytokine
storms in COVID-19 patients.”</em></p>
</blockquote>
<h2>Higher NAD+ Level May Be Protective</h2>
<p>Importantly, he points out that maintaining optimal NAD+
levels may therefore alleviate COVID-19 symptoms. This theory
is further supported by recent data showing “SARS-CoV-2
proteins … deplete NAD+,” and the fact that NAD+ precursors
are known to inhibit inflammation. </p>
<p>Helpful strategies to achieve that include taking NAD
precursors such as nontimed-release niacin, lowering your
sugar intake (as excess blood glucose lowers NAD+), cyclical
nutritional ketosis, and/or taking <a
href="https://articles.mercola.com/sites/articles/archive/2019/02/04/what-is-nadph-and-nox.aspx">glycine
or collagen</a>. </p>
<h2>Other Factors at Play</h2>
<p>Other factors that predispose the elderly to severe infection
and death include epigenetic changes that occur with age,
specifically:</p>
<ul>
<li>The dysregulation of the epigenome</li>
<li>Excessive calorie intake</li>
<li>Changes in glycosylation (the enzymatic process by which
glycans, a type of carbohydrate, are covalently attached to
proteins or fats on the cell surface or in the bloodstream)
</li>
</ul>
<p>Sinclair points out that metformin, a glucose-lowering drug
that inhibits the mTOR pathway, “has been suggested as a
possible drug to combat severe SARS-CoV-2 infection in older
people.”</p>
<p>Metformin also has antiviral effects and helps improve
mitochondrial metabolism, decrease inflammatory cytokines,
decrease cellular senescence and protect against genomic
instability, Sinclair notes. </p>
<p>The following illustrations from his review<sup
style="font-size: 10px;"><span id="edn16"
data-hash="#ednref16">16</span></sup> summarize the
biological mechanisms that determine your COVID-19
susceptibility and subsequent risk of death. </p>
<figure class="center-img">
<img style="max-width:500px;width:100%!important;"
alt="covid-19 susceptibility" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/covid-19-susceptibility.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/covid-19-susceptibility.jpg">
</figure>
<figure class="center-img">
<img style="max-width:500px;width:100%!important;"
alt="covid-19 fatality risk" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/covid-19-fatality-risk.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/covid-19-fatality-risk.jpg">
</figure>
<h2>Vitamin D Is a Simple Strategy That Can Save Lives</h2>
<p>The elderly also tend to have low vitamin D levels, and
vitamin D deficiency is another trend that several researchers
have now identified as an underlying factor that significantly
impacts COVID-19 severity and mortality. I discuss this in “<a
href="https://articles.mercola.com/sites/articles/archive/2020/05/08/vitamin-d-level-correlated-to-covid19-outcomes.aspx">Vitamin
D Is Directly Correlated to COVID-19 Outcome</a>.”</p>
<p>The following graph is from a May 18, 2020, letter<sup
style="font-size: 10px;"><span id="edn17"
data-hash="#ednref17">17</span></sup> to the Federal
Chancellor of Germany, Angela Merkel, from retired biochemist
Bernd Glauner and Lorenz Borsche, in which they highlight
studies<sup style="font-size: 10px;"><span id="edn18"
data-hash="#ednref18">18</span></sup> showing a clear
correlation between COVID-19 mortality and vitamin D levels. </p>
<figure class="center-img">
<img style="max-width:500px;width:100%!important;"
alt="correlation covid 19 death rate" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/public/2020/June/correlation-covid-19-death-rate.jpg"
src="https://media.mercola.com/ImageServer/public/2020/June/correlation-covid-19-death-rate.jpg">
</figure>
<p>It’s important to note that experts are already warning
SARS-CoV-2 may reemerge in the fall when temperatures and
humidity levels drop, thereby increasing the virus’
transmissibility. </p>
<p>To improve your immune function and lower your risk of viral
infections, you’ll want to raise your vitamin D to a level
between 60 nanograms per milliliter (ng/mL) and 80 ng/mL by
fall. In Europe, the measurements you’re looking for are 150
nanomoles per liter (nmol/L) and 200 nmol/L. Optimizing your
vitamin D is particularly important if you are older or have
darker skin. </p>
<p>One of the easiest and most cost-effective ways of measuring
your vitamin D level is to participate in the <a
href="https://www.grassrootshealth.net/">GrassrootsHealth’s</a>
personalized nutrition project, which includes a <a
href="https://shop.mercola.com/product/1090/vitamin-d-test-kit-for-consumer-sponsored-research">vitamin
D testing kit</a>, either alone or in <a
href="https://shop.mercola.com/product/2124/vitamin-d-omega-3-test-kit-for-consumer-sponsored-research">combination
with the omega-3 test</a>. This is done in the convenience
of your home. </p>
<p>To make sure your vitamin D level and immune system function
are optimized, follow these three steps:</p>
<div class="indent">
<p><strong><span class="bullet">1. </span>Measure your
vitamin D level — </strong>Once you know what your blood
level is, you can assess the dose needed to maintain or
improve your level. The easiest way to raise your level is
by getting regular, safe sun exposure, but if you’re very
dark-skinned, you may need to spend about 1.5 hours a day in
the sun to have any noticeable effect. </p>
<p>Those with very light skin may only need 15 minutes a day,
which is far easier to achieve. Still, they too will
typically struggle to maintain ideal levels during the
winter. So, depending on your situation, you may need to use
an oral vitamin D3 supplement. The next question then
becomes, how much do you need?</p>
<p><strong><span class="bullet">2. </span>Assess your
individualized vitamin D dosage — </strong>To do that,
you can either use the chart below, or use
GrassrootsHealth’s <a
href="https://www.grassrootshealth.net/project/dcalculator/">Vitamin
D*calculator</a>. To convert ng/mL into the European
measurement (nmol/L), simply multiply the ng/mL measurement
by 2.5. To calculate how much vitamin D you may be getting
from regular sun exposure in addition to your supplemental
intake, consider using the DMinder app.<sup
style="font-size: 10px;"><span id="edn19"
data-hash="#ednref19">19</span></sup>
</p>
<figure class="center-img">
<img style="width: 100%; max-width: 600px !important;"
alt="Vitamin D - Serum Level" class=" ls-is-cached
mlazyloaded"
data-mlazyload-src="https://media.mercola.com/ImageServer/Public/2020/May/vitamin-d-serum-level.jpg"
src="https://media.mercola.com/ImageServer/Public/2020/May/vitamin-d-serum-level.jpg"></figure>
<p><strong><span class="bullet">3. </span>Retest in three to
six months — </strong>Lastly, you’ll need to remeasure
your vitamin D level in three to six months, to evaluate how
your sun exposure and/or supplement dose is working for you.
</p>
</div>
<p>Not only will optimizing your vitamin D be an important
strategy for you and your family, but it would be really
helpful to start thinking about your community as well. I am
in the process of writing an even more comprehensive and
detailed report on vitamin D in the prevention of COVID-19 and
I hope to enlist ALL of you to talk to your friends and family
and get them on board to get their vitamin levels optimized.</p>
<p>If you can, speak to pastors in churches with large
congregations of people of color and help them start a program
getting people on vitamin D, and if you have a family member
or know anyone who is in an assisted living facility, meet
with the director of the program and encourage them to get
everyone tested or at least start them on vitamin D.</p>
</span>
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