老年呼吸道病毒感染合并血液系统紊乱研究进展

doi:10.3969/j.issn.1003-9198.2026.02.020

Abstract

Abstract: This review systematically outlines recent advances in understanding hematological disorders combined with respiratory viral infections in the elderly. It summarizes core hematological abnormalities—including leukocyte irregularities, thrombocytopenia, anemia, and progressive coagulation dysfunction—induced by influenza virus, respiratory syncytial virus, and SARS-CoV-2, and analyzes their relationships with immunosenescence and chronic inflammatory states. These hematologic alterations do not occur in isolation; rather, in concert with cytokine storm, they can rapidly evolve into disseminated intravascular coagulation or even trigger fatal complications such as secondary hemophagocytic lymphohistiocytosis. Finally, it emphasizes that early and dynamic hematological monitoring should be established as a clinical priority in the management of elderly patients with respiratory viral infections. Future research should focus on elucidating the specific mechanisms of virus-immunosenescence interactions to facilitate the development of stratified management and personalized treatment strategies for the aging population.

Key words: respiratory viral, coagulation dysfunction, immunosenescence, aged, hematology indices

CLC Number:

R 56

YAO Zitong, DANG Xiaoyu, FAN Haoling, ZHU Xiangyu, HUANG Jingjing, FENG Ganzhu. Research advances in hematologic impairments combined with respiratory viral infections in the elderly[J]. Practical Geriatrics, 2026, 40(2): 206-210.

References

[1] Centers for Disease Control and Prevention. Flu and People 65 Years and Older[EB/OL]. (2025-02-14)[2025-07-22] . https://www.cdc.gov/flu/highrisk/65over.htm.
[2] National Institute for Health and Care Excellence. Overview | Pneumonia in adults | Quality standards | NICE[EB/OL]. [2025-07-22] . https://www.nice.org.uk/guidance/QS110.
[3] FERNÁNDEZ MAESTRE I, HARRIS A S, AMOR C. Aging and immunity: the age-old tango[J]. Genes Dev, 2025, 39(15/16): 948-974.
[4] YU S. Comparison of clinical characteristics and peripheral blood tests of COVID-19 and influenza B patients[J]. Am J Trop Med Hyg, 2023, 108(5): 1028-1030.
[5] TIZAZU A M, GIZE A, ALI S. Age influences blood cell-based immune deregulation antibody response and unfavorable clinical outcomes in COVID-19 patients[J]. Sci Rep, 2025, 15(1): 17431.
[6] REN Z F, XIONG R C, WANG L L, et al. The well-defined antiphospholipid syndrome induced by COVID-19: a rare case report and review of the literature[J]. Thromb J, 2024, 22(1): 99.
[7] PRZYBYLOWICZ P K, KLEPINOWSKI T, TARYMA-LES＇NIAK O, et al. Evaluation of methylation changes in blood cells of COVID-19 patients as a biomarker of severity of the infection[J]. BMC Infect Dis, 2025, 25(1): 778.
[8] BADULESCU O V, POPESCU D, CIOCOIU M, et al. Immune thrombocytopenia, severe hematological consequence in a patient with COVID-19: a case report[J]. Exp Ther Med, 2021, 22(3): 1043.
[9] CHOUDHURY S, DUBEY S, ZUMU M, et al. The role of platelet parameters in predicting the disease severity of COVID-19 patients:a hospital-based study[J]. Cureus, 2024, 16(1): e51523.
[10] TSIATSIOU P,TSAIRELI V, MAKRIS M, et al. Transient platelet satellitism and cellular phagocytosis associated with type a influenza virus infection: a case report[J]. Cureus, 2025, 17(3): e79882.
[11] KARAPETYAN A, NIAZYAN L, SHUSHANYAN R, et al. Morphological abnormalities of peripheral blood cells among patients with COVID-19 disease[J]. Heliyon, 2024, 10(2): e24527.
[12] HAEBERER M, MENGEL M, FAN R, et al. RSV risk profile in hospitalized adults and comparison with influenza and COVID-19 controls in Valladolid, Spain, 2010-2022[J]. Infect Dis Ther, 2024, 13(9): 1983-1999.
[13] VERDIER V, LILIENTHAL F, DESVERGEZ A, et al. Severe forms of influenza infections admitted in intensive care units: analysis of mortality factors[J]. Influenza Other Respir Viruses, 2023, 17(7): e13168.
[14] VANGETI S, FALCK-JONES S, YU M, et al. Human influenza virus infection elicits distinct patterns of monocyte and dendritic cell mobilization in blood and the nasopharynx[J]. eLife, 2023, 12: e77345.
[15] OSYODLO G V, HUSIEVA S A, SVICHAROVA S V, et al. Autoimmune hemolytic anemia associated with COVID-19 infection in a patient with high cardio-metabolic risk[J]. Mil Med, 2024, 189(9/10): e2274-e2279.
[16] LEIBRANDT R, ANGELINO K, VIZEL-SCHWARTZ M, et al. Paroxysmal cold hemoglobinuria in an adult with respiratory syncytial virus[J]. Case Rep Hematol, 2018, 2018: 7586719.
[17] MAUGERI N, DE LORENZO R, CLEMENTI N, et al. Unconventional CD147-dependent platelet activation elicited by SARS-CoV-2 in COVID-19[J]. J Thromb Haemost, 2022, 20(2): 434-448.
[18] ZHANG J, HUANG X, DING D, et al. Platelet-driven coagulopathy in COVID-19 patients: in comparison to seasonal influenza cases[J]. Exp Hematol Oncol, 2021, 10(1): 34.
[19] CERIZ T, LAGARTEIRA J, ALVES S R, et al. Disseminated intravascular coagulation in COVID-19 setting:a clinical case description[J]. Cureus, 2023, 15(6): e39941.
[20] CONNORS J M, LEVY J H. COVID-19 and its implications for thrombosis and anticoagulation[J]. Blood, 2020, 135(23): 2033-2040.
[21] QURESHI A I, BASKETT W I, HUANG W, et al. Acute ischemic stroke and COVID-19:an analysis of 27676 patients[J]. Stroke, 2021, 52(3): 905-912.
[22] BACHLER M, BÖSCH J, STÜRZEL D P, et al. Impaired fibrinolysis in critically ill COVID-19 patients[J]. Br J Anaesth, 2021, 126(3): 590-598.
[23] ZHAO Y H, ZHAO L, YANG X C, et al. Cardiovascular complications of SARS-CoV-2 infection (COVID-19):a systematic review and meta-analysis[J]. Rev Cardiovasc Med, 2021, 22(1): 159-165.
[24] ZHANG B, GONG J L, ZENG H L, et al. Unveiling fatal risk factors: predicting hemophagocytic lymphohistiocytosis in SFTS patients[J]. PLoS Negl Trop Dis, 2025, 19(6): e0013207.
[25] MOLINA G, CONTRERAS R, COOMBES K, et al. Hemophagocytic lymphohistiocytosis following COVID-19 infection[J]. Cureus, 2023, 15(1): e34307.
[26] YANG K, XING M Y, JIANG L Y, et al. Infection-associated hemophagocytic syndrome in critically ill patients with COVID-19[J]. Curr Med Sci, 2021, 41(1): 39-45.
[27] LAI S, MERRITT B Y, CHEN L, et al. Hemophagocytic lymphohistiocytosis associated with influenza A (H1N1) infection in a patient with chronic lymphocytic leukemia:an autopsy case report and review of the literature[J]. Ann Diagn Pathol, 2012, 16(6): 477-484.
[28] TANE M, KOSAKO H, SONOKI T, et al. TAFRO syndrome and COVID-19[J]. Biomedicines, 2024, 12(6): 1287.
[29] MILADINOVIC M, KLUSMANN J H. Influenza A (H1N1) virus induced long-term remission in a refractory acute myeloid leukaemia[J]. Br J Haematol, 2023, 202(4): 713-714.

Research advances in hematologic impairments combined with respiratory viral infections in the elderly

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	JIN Jingjing, GU Qiuli, LEI Jaiwei, WANG Jiahe. Research progress on drug targets for age-related hearing loss [J]. Practical Geriatrics, 2026, 40(2): 111-115.
[2]	LI Jiachun, YAN Li, LIU Jiye, SUN Weimin. Research progress on drug targets for sleep disorders in the elderly [J]. Practical Geriatrics, 2026, 40(2): 121-125.
[3]	LIU Beili, CHEN Yonghong, YE Shuai, ZHANG Bin, XIA Qing, SONG Bingyan, ZHU Junyong, JI Hongxia, WU Juan, MENG Qi, XU Xiachi. Effect analysis of etomidate combined with low dose esketamine in anesthesia induction of total hip arthroplasty in elderly patients [J]. Practical Geriatrics, 2026, 40(2): 132-135.
[4]	LU Fengyun, ZHANG Qian, WANG Yanyan, LIU Rui. Clinical characteristics and prognosis analysis of elderly patients with ANCA-associated vasculitis and positive antinuclear antibodies [J]. Practical Geriatrics, 2026, 40(2): 136-141.
[5]	WANG Kun, XIE Jun. Predictive value of HALP score on the onset of frailty in the elderly patients with ischemic stroke [J]. Practical Geriatrics, 2026, 40(2): 142-146.
[6]	ZHANG Yang, YANG Shun, LU Ziru, SHA Lili. Analysis of the median effective dose and adverse effects of methylene blue combined with ropivacaine for fascia iliaca compartment block in postoperative analgesia in elderly patients undergoing hip arthroplasty [J]. Practical Geriatrics, 2026, 40(2): 154-158.
[7]	ZHONG Hailong, ZHONG Changzheng, ZHONG Qiong, WANG Kuiyuan, GUO Yanyan, HU Jianhua. Impact of artificial intelligence-assisted multi-cognitive domain training on elderly patients with mild cognitive impairment: a randomized controlled trial among community-dwelling elderly individuals [J]. Practical Geriatrics, 2026, 40(2): 159-163.
[8]	CAO Yaolin, HUANG Yuming, YANG Jinpeng, WANG Wei, ZHOU Yue, LI Menglan. Predictive study of lymph node metastasis in elderly patients with superficial esophageal squamous cell carcinoma [J]. Practical Geriatrics, 2026, 40(2): 169-173.
[9]	LYU Jiajia, ZHONG Xiaoyou, GAO Yiteng, WANG Lin, FAN Weifei. Cancer pain management in the elderly: insights from the NCCN Guidelines Version 2.2025 Adult Cancer Pain [J]. Practical Geriatrics, 2026, 40(2): 211-216.
[10]	LI Yanlin, SUN Jinbing. Progress in diagnosis and treatment of constipation in the elderly [J]. Practical Geriatrics, 2026, 40(1): 11-15.
[11]	WANG Jinfeng, SONG Jiao, JIANG Yangyang, YANG Xue, LI Ying. Association between sleep quality and depressive symptoms in residents with cognitive impairment residing in nursing homes [J]. Practical Geriatrics, 2026, 40(1): 16-20.
[12]	LIU Mengjie, DU Qiuyao, CHEN Xiaoxiao, ZHANG Zequn, ZENG Yang, LEI Shiyu, ZHANG Qing. Predictive value of non-HDL-C/HDL-C for coronary artery calcification in older patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2026, 40(1): 21-25.
[13]	LU Yue, CHEN Jinjin, ZHU Chengyuan, ZHOU Liang, FENG Chun, LIN Feng. A decision-making tool for ICF-based community rehabilitation in elderly patients with chronic stroke incorporating difficulty and intervention benefit scales [J]. Practical Geriatrics, 2026, 40(1): 32-37.
[14]	BO Yun, WANG Qi, YANG Lianqianzi, ZHU Jinyu, ZHANG Yuanyuan. Association of sleep quality with frailty among adults aged 80 years and older in an integrated medical and long-term care institution [J]. Practical Geriatrics, 2026, 40(1): 38-42.
[15]	TAO Lu, XIA Zeyan. Association between frailty and apathy in community-dwelling elderly adults [J]. Practical Geriatrics, 2026, 40(1): 43-47.