COVID-19 and the elderly: insights into pathogenesis and clinical decision-making

The elderly may represent a specific cluster of high-risk patients for developing COVID-19 with rapidly progressive clinical deterioration. Indeed, in older individuals, immunosenescence and comorbid disorders are more likely to promote viral-induced cytokine storm resulting in life-threatening resp...

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Published inAging clinical and experimental research Vol. 32; no. 8; pp. 1599 - 1608
Main Authors Perrotta, Fabio, Corbi, Graziamaria, Mazzeo, Grazia, Boccia, Matilde, Aronne, Luigi, D’Agnano, Vito, Komici, Klara, Mazzarella, Gennaro, Parrella, Roberto, Bianco, Andrea
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.08.2020
Springer Nature B.V
Subjects
Aged
Aged, 80 and over
Aging
Betacoronavirus
Clinical Decision-Making
Clinical deterioration
Coronavirus Infections
Coronaviruses
COVID-19
Cytokines - immunology
Geriatrics/Gerontology
Humans
Medicine
Medicine & Public Health
Older people
Pandemics
Pathogenesis
Pneumonia, Viral
Respiratory failure
Review
SARS-CoV-2
Nursing homes
COVID-19 Elderly patients
Coronavirus
Palliation
Sars-Cov-2
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Summary:The elderly may represent a specific cluster of high-risk patients for developing COVID-19 with rapidly progressive clinical deterioration. Indeed, in older individuals, immunosenescence and comorbid disorders are more likely to promote viral-induced cytokine storm resulting in life-threatening respiratory failure and multisystemic involvement. Early diagnosis and individualized therapeutic management should be developed for elderly subjects based on personal medical history and polypharmacotherapy. Our review examines the pathogenesis and clinical implications of ageing in COVID-19 patients; finally, we discuss the evidence and controversies in the management in the long-stay residential care homes and aspects of end-of-life care for elderly patients with COVID-19.
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ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-020-01631-y