Biological Aging Predicts Vulnerability to COVID-19 Severity in UK Biobank Participants

Chia Ling Kuo, Luke C. Pilling, Janice L. Atkins, Jane A.H. Masoli, João Delgado, Christopher Tignanelli, George A. Kuchel, David Melzer, Kenny B Beckman, Morgan E. Levine

Research output: Contribution to journalArticlepeer-review


Background: Age and disease prevalence are the 2 biggest risk factors for Coronavirus disease 2019 (COVID-19) symptom severity and death. We therefore hypothesized that increased biological age, beyond chronological age, may be driving disease-related trends in COVID-19 severity. Methods: Using the UK Biobank England data, we tested whether a biological age estimate (PhenoAge) measured more than a decade prior to the COVID-19 pandemic was predictive of 2 COVID-19 severity outcomes (inpatient test positivity and COVID-19-related mortality with inpatient test-confirmed COVID-19). Logistic regression models were used with adjustment for age at the pandemic, sex, ethnicity, baseline assessment centers, and preexisting diseases/conditions. Results: Six hundred and thirteen participants tested positive at inpatient settings between March 16 and April 27, 2020, 154 of whom succumbed to COVID-19. PhenoAge was associated with increased risks of inpatient test positivity and COVID-19-related mortality (ORMortality = 1.63 per 5 years, 95% CI: 1.43-1.86, p = 4.7 × 10-13) adjusting for demographics including age at the pandemic. Further adjustment for preexisting diseases/conditions at baseline (ORM = 1.50, 95% CI: 1.30-1.73 per 5 years, p = 3.1 × 10-8) and at the early pandemic (ORM = 1.21, 95% CI: 1.04-1.40 per 5 years, p =. 011) decreased the association. Conclusions: PhenoAge measured in 2006-2010 was associated with COVID-19 severity outcomes more than 10 years later. These associations were partly accounted for by prevalent chronic diseases proximate to COVID-19 infection. Overall, our results suggest that aging biomarkers, like PhenoAge may capture long-term vulnerability to diseases like COVID-19, even before the accumulation of age-related comorbid conditions.

Original languageEnglish (US)
Pages (from-to)E133-E141
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number8
StatePublished - Jul 13 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s). Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.


  • Biological age
  • Biomarkers
  • Phenotypic age
  • UK Biobank

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


Dive into the research topics of 'Biological Aging Predicts Vulnerability to COVID-19 Severity in UK Biobank Participants'. Together they form a unique fingerprint.

Cite this