Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun;28(6):785-791.
doi: 10.1016/j.cmi.2022.02.040. Epub 2022 Mar 11.

Caring for older adults during the COVID-19 pandemic

Virginie Prendki  1 , Giusy Tiseo  2 , Marco Falcone  3 ; ESCMID Study Group for Infections in the Elderly (ESGIE)
Affiliations
Review

Caring for older adults during the COVID-19 pandemic

Virginie Prendki et al. Clin Microbiol Infect. 2022 Jun.

Abstract

Background: Elderly patients represent a high-risk group with increased risk of death from COVID-19. Despite the number of published studies, several unmet needs in care for older adults exist.

Objectives: To discuss unmet needs of COVID-19 in this special population.

Sources: A literature review for studies on COVID-19 in elderly patients published between December 2019 and November 2021 was performed. Clinical questions were formulated to guide the literature search. The search was conducted in the MEDLINE database, combining specific search terms. Two reviewers independently conducted the search and selected the studies according to the prespecified clinical questions.

Content: Elderly patients with COVID-19 have peculiar characteristics. They may have atypical clinical presentation, with no fever and with delirium or neurological manifestations as the most common signs, with potential delayed diagnosis and increased risk of death. The reported fatality rates among elderly patients with COVID-19 are extremely high. Several factors, including comorbidities, atypical presentation, and exclusion from intensive care unit care, contribute to this excess of mortality. Age alone is frequently used as a key factor to exclude the elderly from intensive care, but there is evidence that frailty rather than age better predicts the risk of poor outcome in this category. Durability of vaccine efficacy in the elderly remains debated, and the need for a third booster dose is becoming increasingly evident. Finally, efforts to care for elderly patients who have survived after acute COVID-19 should be implemented, considering the high rates of long COVID sequelae and the risk of longitudinal functional and cognitive decline.

Implications: We highlight peculiar aspects of COVID-19 in elderly patients and factors contributing to high risk of poor outcome in this category. We also illuminated gaps in current evidence, suggesting future research directions and underlining the need for further studies on the optimal management of elderly patients with COVID-19.

Keywords: COVID-19; Elderly; Frailty; Geriatric; Long COVID; Older; SARS-CoV-2; Vaccines.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Long COVID sequelae frequently reported in the elderly and actions to be implemented.
See this image and copyright information in PMC

References

    1. Bonanad C., García-Blas S., Tarazona-Santabalbina F., Sanchis J., Bertomeu-González V., Fácila L., et al. The effect of age on mortality in patients with Covid-19: a meta-analysis with 611,583 subjects. J Am Med Dir Assoc. 2020;21:915–918. - PMC - PubMed
    1. Kennedy M., Helfand B.K.I., Gou R.Y., Gartaganis S.L., Webb M., Moccia J.M., et al. Delirium in older patients with COVID-19 presenting to the Emergency Department. JAMA Netw Open. 2020;3 - PMC - PubMed
    1. WHO Weekly epidemiological update on COVID-19. 2021. https://www.who.int/publications/m/item/weekly-epidemiological-update-on... Available at:
    1. Olabi B., Bagaria J., Bhopal S.S., Curry G.D., Villarroel N., Bhopal R. Population perspective comparing COVID-19 to all and common causes of death during the first wave of the pandemic in seven European countries. Public Health Pract (Oxf) 2021;2:100077. - PMC - PubMed
    1. Knock E.S., Whittles L.K., Lees J.A., Perez-Guzman P.N., Verity R., FitzJohn R.G., et al. Key epidemiological drivers and impact of interventions in the 2020 SARS-CoV-2 epidemic in England. Sci Transl Med. 2021;13 - PMC - PubMed