Therapy strategies for elderly critically ill patients with novel coronavirus pneumonia

doi:10.3877/cma.j.issn.2096-1537.2022.03.015

Abstract

Abstract:

Due to old age, underlying diseases, and weak organ compensatory function, elderly patients with novel coronary pneumonia (COVID-19) are prone to deteriorate. This article summarizes the experience in the treatment of elderly patients with COVID-19. On the basis of the COVID-19 itself treatment, the strategies emphasize on underlying diseases therapy, organ function support and complication prevention, early assessment of the patients' risk factors, rehabilitation practice and psychological care. The review can provide the clinical evidence of similar elderly patients in the future.

Key words: Novel coronavirus pneumonia, Elderly critically ill patients, Respiratory failure, Therapy strategy

Shuyuan Qian, Xiaoqing Li, Yingzi Huang, Yi Yang, Chun Pan, Haibo Qiu. Therapy strategies for elderly critically ill patients with novel coronavirus pneumonia[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(03): 267-271.

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References 32

1	WHO. WHO Coronavirus Disease (COVID-19) Dashboard [EB/OL]. (2022-06-13) [2022-07-15]. URL
2	COVID-19 Forecasting Team. Variation in the COVID-19 infection-fatality ratio by age, time, and geography during the pre-vaccine era: a systematic analysis [J]. Lancet, 2022, 399(10334): 1469-1488.
3	Salinas-Aguirre JE, Sanchez-Garcia C, Rodriguez-Sanchez R, et al. Clinical characteristics and comorbidities associated with mortality in patients with COVID-19 in Coahuila (Mexico) [J]. Rev Clin Esp (Barc), 2022, 222(5): 288-292.
4	Leung C. Risk factors for predicting mortality in elderly patients with COVID-19: a review of clinical data in China [J]. Mech Ageing Dev, 2020, 188: 111255.
5	Duggan MC, Van J, Ely EW. Delirium assessment in critically ill older adults: considerations during the COVID-19 pandemic [J]. Crit Care Clin, 2021, 37(1): 175-190.
6	Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019 [J]. N Engl J Med, 2020, 382(8): 727-733.
7	Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy [J]. JAMA, 2020, 323(18): 1775-1776.
8	Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area [J]. JAMA, 2020, 323(20): 2052-2059.
9	Tsukagoshi H, Shinoda D, Saito M, et al. Relationships between viral load and the clinical course of COVID-19 [J]. Viruses, 2021, 13(2): 304.
10	Nicoli F, Solis-Soto MT, Paudel D, et al. Age-related decline of de novo T cell responsiveness as a cause of COVID-19 severity [J]. Geroscience, 2020, 42(4): 1015-1019.
11	Singhal S, Kumar P, Singh S, et al. Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis [J]. BMC Geriatr, 2021, 21(1): 321.
12	Alves VP, Casemiro FG, Araujo BG, et al. Factors associated with mortality among elderly people in the COVID-19 pandemic (SARS-CoV-2): a systematic review and meta-analysis [J]. Int J Environ Res Public Health, 2021, 18(15): 8008.
13	Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study [J]. Lancet, 2021, 397(10270): 220-232.
14	Geen O, Rochwerg B, Wang XM. Optimizing care for critically ill older adults [J]. CMAJ, 2021, 193(39): E1525-E1533.
15	国家卫生健康委, 国家中医药管理局. 新型冠状病毒肺炎诊疗方案(试行第九版) [EB/OL].(2022-06-28)[2022-07-15]. URL
16	Najjar-Debbiny R, Gronich N, Weber G, et al. Effectiveness of Paxlovid in reducing severe COVID-19 and mortality in high risk patients [J]. Clin Infect Dis, 2022, 2: ciac443.
17	Libster R, Perez Marc G, Wappner D, et al. Early high-titer plasma therapy to prevent severe Covid-19 in older adults [J]. N Engl J Med, 2021, 384(7): 610-618.
18	Pan C, Chen H, Xie J, et al. The efficiency of convalescent plasma therapy in the management of critically ill patients infected with COVID-19: a matched cohort study [J]. Front Med (Lausanne), 2022, 9: 822821.
19	Falcone M, Tiseo G, Valoriani B, et al. Efficacy of Bamlanivimab/Etesevimab and Casirivimab/Imdevimab in preventing progression to severe COVID-19 and role of variants of concern [J]. Infect Dis Ther, 2021, 10(4): 2479-2488.
20	Sun Q, Qiu H, Huang M, et al. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province [J]. Ann Intensive Care, 2020, 10(1): 33.
21	Hanley B, Naresh KN, Roufosse C, et al. Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study [J]. Lancet Microbe, 2020, 1(6): e245-e253.
22	Di Minno A, Ambrosino P, Calcaterra I, et al. COVID-19 and venous thromboembolism: a meta-analysis of literature studies [J]. Semin Thromb Hemost, 2020, 46(7): 763-771.
23	Garcia-Vidal C, Sanjuan G, Moreno-Garcia E, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study [J]. Clin Microbiol Infect, 2021, 27(1): 83-88.
24	Perez-Granda MJ, Carrillo CS, Rabadan PM, et al. Increase in the frequency of catheter-related bloodstream infections during the COVID-19 pandemic: a plea for control [J]. J Hosp Infect, 2022, 119: 149-154.
25	Bashardoust P, Fano BJ. Incidence of COVID-19-associated venous thromboembolism among hospitalized patients in McAllen, Texas, USA, in Late 2021 [J]. Cureus, 2022, 14(3): e23270.
26	Klok FA, Kruip M, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19 [J]. Thromb Res, 2020, 191: 145-147.
27	Amini M, Mansouri F, Vafaee K, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: Retrospective cohort study [J]. Int Wound J, 2022, 2: 1-16.
28	Kottner J, Cuddigan J, Carville K, et al. Prevention and treatment of pressure ulcers/injuries: the protocol for the second update of the international clinical practice guideline 2019 [J]. J Tissue Viability, 2019, 28(2): 51-58.
29	Goodwin VA, Allan L, Bethel A, et al. Rehabilitation to enable recovery from COVID-19: a rapid systematic review [J]. Physiotherapy, 2021, 111: 4-22.
30	Lithander FE, Neumann S, Tenison E, et al. COVID-19 in older people: a rapid clinical review [J]. Age Ageing, 2020, 49(4): 501-515.
31	Cimerman M, Jesensek Papez B. The impact of COVID-19 pandemic on the rehabilitation of patients after arthroscopic knee surgery at IPRM in UCM Maribor, Slovenia [J]. Bratisl Lek Listy, 2022, 123(4): 262-267.
32	Santini ZI, Jose PE, York Cornwell E, et al. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis [J]. Lancet Public Health, 2020, 5(1): e62-e70.

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