Elderly at Higher Risk as COVID-19 Triggers Dangerous Drop in Chenodeoxycholic Acid and Glycochenodeoxycholic Acid
Nikhil Prasad Fact checked by:Thailand Medical News Team Jun 29, 2025 5 hours, 48 minutes ago
Medical News: Elderly COVID-19 Patients Face Unique Dangers
New research from top Chinese medical institutions has uncovered a troubling link between severe COVID-19 in elderly patients and a drastic drop in two important bile acids—Chenodeoxycholic Acid and Glycochenodeoxycholic Acid. These compounds, which play a key role in controlling inflammation in the body, may serve as powerful early warning signs of worsening disease. The study was led by researchers from the Senior Department of Infectious Diseases at the Fifth Medical Center of Chinese PLA General Hospital, the Department of Pulmonary and Critical Care Medicine at the Seventh Medical Center, and the Yu-Yue Pathology Scientific Research Center in Chongqing.
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Elderly at Higher Risk as COVID-19 Triggers Dangerous Drop in Chenodeoxycholic Acid
and Glycochenodeoxycholic Acid
Using blood samples and cellular experiments, the team discovered that low levels of Chenodeoxycholic Acid and Glycochenodeoxycholic Acid were directly linked to the likelihood of developing severe COVID-19. In fact, patients whose levels were already low at hospital admission were far more likely to progress into critical stages, often needing longer hospital stays and more intensive treatment.
According to this new study covered in this
Medical News report, this breakthrough could give doctors new tools to monitor and treat elderly patients before their condition deteriorates.
What These Bile Acids Do and Why Their Decline Is Dangerous
Bile acids, beyond aiding digestion, help regulate the immune system. Specifically, Chenodeoxycholic Acid (CDCA) and Glycochenodeoxycholic Acid (GCDCA) interact with receptors known as FXR and TGR5. These receptors can reduce the body’s inflammatory response, something crucial in diseases like COVID-19, where excessive inflammation—known as a cytokine storm—can cause organ failure and death.
In laboratory tests using human immune cells (THP-1 monocytes), scientists found that both CDCA and GCDCA suppressed major inflammatory markers such as IL-6, IL-1β, and TNF-α after SARS-CoV-2 exposure. Interestingly, these bile acids acted through the NOD-like receptor signaling pathway, a key regulator of inflammation. When this pathway is hyperactive, the immune system can spiral out of control.
Predicting Disease Severity Before It Happens
One of the most critical aspects of the research was its ability to show how early measurements of CDCA and GCDCA levels could help predict whether a patient will worsen. By comparing elderly patients who progressed to severe disease against those who did not, the study found that lower levels of these bile acids at the time of hospital admission were highly predictive of a bad outcome.
Statistical analysis revealed that among the different clinical and immune-related indicators, decreased CDCA was one of the top three predictors of disease progression, alongside high neutrophil counts and elevated IL-6. R
OC curve analysis also showed that CDCA had the best performance as a predictive marker, with an optimal threshold identified at 36.77 ng/mL. Patients below this level were at significantly greater risk of severe illness.
Implications for Treatment and Prevention
Beyond diagnostics, this research also opens the door to possible treatments. Since CDCA and GCDCA can directly control inflammation in SARS-CoV-2-infected cells, they might one day be used as therapies. Moreover, the way they activate FXR and TGR5 receptors offers a clearer picture of how future drugs might be designed to protect older adults during viral outbreaks.
Importantly, these findings may help researchers understand why older individuals—especially those with underlying health conditions—respond so poorly to COVID-19. The decline in Chenodeoxycholic Acid and Glycochenodeoxycholic Acid seems to impair the body's natural ability to control inflammation, setting off a chain reaction that could end in severe disease.
The study findings were published in the peer reviewed journal: Biomolecules.
https://www.mdpi.com/2218-273X/15/7/943
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