Systemic inflammation drives the severe response to infection

Systemic inflammation describes a chronic state of mostly sterile inflammation. In other words, it describes a steady-state of inflammation with no immediate infectious cause.

Different factors drive this state of chronic inflammation. For one, it increases with age. Furthermore, lifestyle plays a very important role, with obesity and behaviors that drive it increasing it as well.

Ultimately, this chronic state of systemic inflammation increases our risk of death, primarily from the chronic diseases of aging. These diseases include:

  • Cardiovascular disease
  • Type 2 diabetes
  • Obesity
  • Autoimmune conditions(Arthritis, allergies, asthma, etc.)
  • Neurodegenerative diseases(Alzheimer’s, Parkinson’s)
  • Cancer

But the increased risk of death in people with high levels of chronic inflammation isn’t relegated to chronic disease. Having high levels of systemic inflammation also increases your risk of death from infection. This includes viral, bacterial, and fungal infections.

This is of particular relevance now given the spread of SARS-CoV2. Many people want to reduce their risk of having a severe case of COVID19.

Based on the data, reducing chronic inflammation is a prime target for preventing severe COVID19.

Risk factors associated with severe COVID19 are chronic inflammatory diseases

Since the beginning of the COVID19 pandemic, we’ve known that age is a significant risk factor for severe illness. Certainly this is a concern, but not one we can address. You can’t change your age.

Be that as it may, it does hint that chronic inflammation plays a role. As a result of growing older, inflammation increases.

Furthermore, co-morbidities that dramatically increase your risk for severe illness come packaged with high levels of inflammation. Those co-morbidities and the amount they increase the risk for severe COVID-19 illness include:

  • Obesity (3.1x increase)
  • Asthma (2.3x increase)
  • History of congestive heart failure (6x increase)
  • Cerebrovascular disease (4.9x increase)
  • Diabetes (3.4x increases)

But are these illnesses themselves driving increased risk? Or is the persistent inflammatory state the underlying driver of severe illness?

Systemic inflammation and risk of severe response to infection

You may recall a recent blog discussing an inflammatory marker known as GlycA. Evidence indicates that GlycA is a new and effective measure of chronic inflammation. Furthermore, GlycA associates with various inflammatory diseases, acting as a biomarker of chronic disease risk.

GlycA is a more stable way to measure your background level of chronic inflammation than CRP. Most importantly, it’s a composite marker of chronic inflammation, measuring acute phase protein acetylation. As a result, it gives us a better read on systemic inflammation.

Interestingly, people with high GlycA have an increased risk of severe response to microbial infection. Consequently, people with high GlycA who experience a viral, bacterial, or fungal infection are more likely to be hospitalized or die from this infection.

Systemic inflammation and infection risk

Most importantly, having lower GlycA levels seems to protect people from sepsis and pneumonia. Sepsis and pneumonia are common causes of death in people with severe COVID-19 illness. In one paper, 22 out of 26 people who died of COVID-19 had one or both listed as the cause of death.

And a new paper looking at biomarkers for severe COVID-19 illness found that people with higher GlycA had a 2-4x greater risk for severe illness than those with lower levels.

Therefore, maintaining low levels of systemic inflammation may be an important way to reduce your risk of severe illness due to infection.

Your lifestyle is the most important modifiable factor for reducing systemic inflammation. I discussed the main ways I approach this in a blog you can read here.

Check it out and begin implementing these simple behaviors to make yourself more resilient to microbial infections.

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