Annals of Medicine (Dec 2023)

Approach to COVID-19 in older adults and indications for improving the outcomes

  • Claudio Tana,
  • Livia Moffa,
  • Katia Falasca,
  • Jacopo Vecchiet,
  • Marco Tana,
  • Cesare Mantini,
  • Fabrizio Ricci,
  • Andrea Ticinesi,
  • Tiziana Meschi,
  • Francesco Cipollone,
  • Maria Adele Giamberardino

DOI
https://doi.org/10.1080/07853890.2023.2265298
Journal volume & issue
Vol. 55, no. 2

Abstract

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AbstractBackground: COVID-19 continues to present challenges in the care of older adults with frailty and/or comorbidities and very old patients, who can be hospitalized with severe COVID-19 despite full vaccination. Frailty is a heterogeneous syndrome characterized by an increased aging-related vulnerability due to a reduced physiological reserve and function of systemic organs, and is associated with an impairment of activities of daily living. Frail older adults remain at elevated risk of mortality from COVID-19 compared to older adults without frailty, and some pre-existing risk factors such as malnutrition, prolonged bed rest, and the association with comorbidities can aggravate the SARS-CoV-2 infection. Furthermore, the severity of COVID-19 can impact on long-term functioning of older patients surviving from the infection. Persistent symptoms are another emerging problem of the post-vaccination phase of pandemic, as most patients suffer from chronic symptoms which can become debilitating and affect the daily routine. Aim of this review: In this complex relationship, the evaluation of COVID-19 in vulnerable categories is still a matter of high interest and personalized care plans based on a comprehensive geriatric assessment, tailored interventions; specific therapeutic algorithms among older adults are thus recommended in order to improve the outcomes.

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