# Age related loss of immune resilience during response to severe respiratory viral infections

> **NIH NIH U01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $528,011

## Abstract

Abstract. The clinical responses to respiratory viruses are very heterogenous as recently demonstrated by the
COVID-19 pandemic with most aggressive clinical courses among elders, suffering the highest mortality. The
pathophysiological mechanisms leading to poor outcome among elders people are not well understood. Beyond
the increased mortality seen in advanced age group, older critically ill COVID-19 patients (>65yo) had higher
viral loads in their lower airways and blunted anti-SARS-CoV-2 immune responses. Using host transcriptomic
approaches described in our preliminary data we are identifying a pattern suggestive of maladaptive immune
responses, more prominently present among elders, that leads to poor outcomes in patients with respiratory
viruses. In addition, through a collaboration between Drs. Segal, Zhang and Forst, we have identified age-related
signatures that are distinct from the lower airway and systemic transcriptome. Interestingly, some of these signals
are also seen in a cohort of patients with influenza virus infections, suggesting a novel profiling that may uncover
important mechanisms of immunoaging. Thus, using samples and data collected from patients with SARS-CoV-
2 or influenza infection, we will test the hypothesis that among older patients with respiratory virus infections,
poor prognosis is characterize by maladaptive host immune responses characterized by downregulation
of type 1 interferon (IFN) responses and increased inflammatory injury, thereby suppressing immune
mechanisms designed to limit viral load. Here, in Aim 1 we will focus on lower airway and blood samples
from critically ill COVID-19 patients. In these, we will use RNA sequencing and single cell RNA
sequencing to evaluate for longitudinal host immune signatures associated with poor outcome among
different age groups. Then in Aim 2 we will establish multiscale gene network models associated with
poor outcome among different age groups of critically ill COVID-19 patients. Then, in Aim 3 we will
perform a comparative study of age-dependent host immune response signatures and network models
in COVID-19 and influenza virus infection. Therefore, this is an unprecedented opportunity to conduct
investigations on paired lower airway and systemic samples from patients suffering infections with respiratory
viruses across different age segments in order to identify novel mechanisms that lead to poor viral control and
clinical outcomes.

## Key facts

- **NIH application ID:** 10786447
- **Project number:** 1U01AG088351-01
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** CHRISTIAN FORST
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $528,011
- **Award type:** 1
- **Project period:** 2024-07-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10786447

## Citation

> US National Institutes of Health, RePORTER application 10786447, Age related loss of immune resilience during response to severe respiratory viral infections (1U01AG088351-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10786447. Licensed CC0.

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