Caring for older adults during the COVID-19 pandemic.
Caring for older adults during the COVID-19 pandemic.
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DOI：
10.1016/j.cmi.2022.02.040
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
ESCMID Study Group for Infections in the Elderly (ESGIE)
中科院分区：
文献类型：
--
作者：
Prendki V;Tiseo G;Falcone M;ESCMID Study Group for Infections in the Elderly (ESGIE)
老年患者是高风险群体，其死于COVID-19的风险增加。尽管发表了大量研究，但仍存在一些未满足的老年人护理需求。讨论COVID-19在这一特殊人群中未得到满足的需求。对2019年12月至2021年11月期间发表的老年患者COVID-19研究进行了文献综述。制定临床问题以指导文献检索。在MEDLINE数据库中进行检索，结合特定检索词。两名评审员独立进行检索，并根据预先指定的临床问题选择研究。老年COVID-19患者具有特殊的特征。他们可能有非典型的临床表现，没有发烧和谵妄或神经系统的表现为最常见的迹象，与潜在的延误诊断和死亡的风险增加。据报告，老年COVID-19患者的死亡率极高。多种因素，包括合并症、非典型表现和被排除在重症监护病房外，导致了死亡率过高。年龄本身经常被用作将老年人排除在重症监护之外的关键因素，但有证据表明，虚弱而不是年龄更能预测这一类别中不良结局的风险。老年人疫苗效力的持久性仍然存在争议，第三次加强剂量的必要性越来越明显。最后，考虑到长期COVID后遗症的高发生率以及纵向功能和认知能力下降的风险，应努力照顾急性COVID-19后幸存的老年患者。我们强调了COVID-19在老年患者中的特殊方面以及导致这类患者预后不良的高风险因素。我们还阐明了目前证据中的差距，提出了未来的研究方向，并强调需要进一步研究COVID-19老年患者的最佳管理。
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. To discuss unmet needs of COVID-19 in this special population. 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. 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. 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.
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影响因子：
8.1
作者：
Dres M;Hajage D;Lebbah S;Kimmoun A;Pham T;Béduneau G;Combes A;Mercat A;Guidet B;Demoule A;Schmidt M;COVID-ICU investigators
通讯作者：
COVID-ICU investigators
影响因子：
4.2
作者：
Falcone M;Tiseo G;Barbieri G;Galfo V;Russo A;Virdis A;Forfori F;Corradi F;Guarracino F;Carrozzi L;Celi A;Santini M;Monzani F;De Marco S;Pistello M;Danesi R;Ghiadoni L;Farcomeni A;Menichetti F;Pisa COVID-19 Study Group
通讯作者：
Pisa COVID-19 Study Group
影响因子：
64.5
作者：
Hoffmann M;Krüger N;Schulz S;Cossmann A;Rocha C;Kempf A;Nehlmeier I;Graichen L;Moldenhauer AS;Winkler MS;Lier M;Dopfer-Jablonka A;Jäck HM;Behrens GMN;Pöhlmann S
通讯作者：
Pöhlmann S
DOI：
10.1056/nejmoa2105290
发表时间：
2021-12-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
Falsey AR;Sobieszczyk ME;Hirsch I;Sproule S;Robb ML;Corey L;Neuzil KM;Hahn W;Hunt J;Mulligan MJ;McEvoy C;DeJesus E;Hassman M;Little SJ;Pahud BA;Durbin A;Pickrell P;Daar ES;Bush L;Solis J;Carr QO;Oyedele T;Buchbinder S;Cowden J;Vargas SL;Guerreros Benavides A;Call R;Keefer MC;Kirkpatrick BD;Pullman J;Tong T;Brewinski Isaacs M;Benkeser D;Janes HE;Nason MC;Green JA;Kelly EJ;Maaske J;Mueller N;Shoemaker K;Takas T;Marshall RP;Pangalos MN;Villafana T;Gonzalez-Lopez A;AstraZeneca AZD1222 Clinical Study Group
通讯作者：
AstraZeneca AZD1222 Clinical Study Group
影响因子：
3.3
作者：
Gomez-Belda, Ana B.;Fernandez-Garces, Mar;Artero, Arturo
通讯作者：
Artero, Arturo