Allostatic Load as a Short-Term Prognostic and Predictive Marker

Stress Health. 2025 Feb;41(1):e3527. doi: 10.1002/smi.3527.

Abstract

It would be highly valuable to possess a tool for evaluating disease progression and identifying patients at risk of experiencing a more severe clinical course and potentially worse outcomes. The concept of allostatic load, which represents the overall strain on the body from repeated stress responses, has been recognized as a precursor to the development of chronic illnesses. It functions as a cumulative measure of the body's capacity to adapt to stress. Numerous studies have demonstrated that elevated allostatic load levels are associated with various negative health outcomes, both physical and mental, and are more predictive of mortality than individual biomarkers. Leveraging the unique circumstances presented by the COVID-19 pandemic, we evaluated different clinical and laboratory parameters in hospitalised COVID-19 patients to assess allostatic load. Our results indicated that allostatic load acts as a strong predictor of prolonged hospitalisation, increased ICU days, and mortality. This highlights its efficacy as a precise gauge of biological dysregulation linked to the response to COVID-19 during disease progression. Allostatic load is easily obtainable and provides an early, cost-effective indication of disease prognosis. Additionally, it has the potential to forecast the necessity for ICU admission. As a result, this parameter, indicative of the comprehensive physiological disruption in response to stress, emerges as a promising prognostic marker for hospitalised patients, extending beyond COVID-19.

Keywords: allostatic load; biological dysregulation; biomarkers; stress responses.

MeSH terms

  • Adult
  • Aged
  • Allostasis* / physiology
  • Biomarkers*
  • COVID-19* / physiopathology
  • Disease Progression
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • SARS-CoV-2
  • Stress, Psychological / metabolism

Substances

  • Biomarkers