Respiratory viral infections in the elderly: From the perspective of the aging immune system

The susceptibility of the elderly to respiratory viral infections and the challenges posed by an aging population necessitate imperative development of advanced preventive and therapeutic strategies for elderly individuals. The clinical outcome of such infections is intricately determined by the complex interplay among viruses, host tissues, and immune cells. Elderly individuals exhibit a diminished efficacy of their immune system to clear viruses, consequently leading to prolonged viral insults, tissue damage, and an excessive activation of inflammatory cells. These ultimately result in worse clinical outcomes. Targeting the dysregulated antiviral immune responses has emerged as a potential approach to improve the prognosis of geriatric patients. It is noteworthy that the impacts of aging on antiviral immune responses are highly heterogenous. Thus, individualized patient assessment and management assume paramount importance. This review aims to summarize the current evidence elucidating the effects of aging on immune responses to respiratory viruses, with the ultimate goal of identifying knowledge gaps that can inform future research and enhance the management of elderly individuals.