Infection à Covid-19 en gériatrie au Sénégal

OBJECTIVES: While the elderly incurred high mortality during the Covid-19 pandemic, the geriatric particularities remain little known. The objective of this work was to determine the geriatric specificities, in particular epidemiological, diagnostic and therapeutic, of this infection in Senegal. METHODS: This was a retrospective, descriptive, observational study over a period of 13 months (beginning of August 2020 to end of August 2021) conducted in a population of individuals aged 65 years and older admitted to the only university geriatric department in Senegal. Patients infected with COVID-19 confirmed by a positive RT-PCR (reverse transcriptase polymerase chain reaction) and nasal or pharyngeal swabs were included. RESULTS: During this period, out of 215 hospitalized patients, 40 tested positive for Covid-19, a proportion of 18.6%. The mean age of the patients was 79 years (±7), predominantly male (65%). Most patients (45%) came from the hospital emergency department. Frailty concerned 67.5% of the patients and 25% had a chronic loss of autonomy. Clinical signs were dominated by alteration of the general state and pulmonary condensation syndrome, each affecting half of the patients, followed by fever (40%), anorexia (35%), dyspnea (32.5%) and transit disorders (25%). The geriatric syndromes were mainly loss of functional autonomy for 77.5% of the patients, malnutrition for 67.5%, confusional syndrome for 25% and depression for 25%. On the thoracic CT scan, the extent of the lesions was severe for half of the patients with extensive forms for 25% of the patients, severe for 22.5% and critical for 2.5%. All patients received antibiotic therapy based on azithromycin and 57.5% received amoxicillin-clavulanic acid while only 7.5% received hydroxychloroquine. Non-drug treatments were mainly motor rehabilitation for 80% of the patients, nutritional management for 77.5%, supportive psychotherapy for 50% and temporo-spatial reorientation protocols for confusion for 30%. Complications were dominated by acute renal failure (47.5%), ionic disorders (42.5%) and bacterial superinfections (22.5%). The mortality rate was 20%. CONCLUSION: This study, in addition to confirming the atypical nature of the symptomatology and the severity of the pulmonary involvement, has above all highlighted the multidimensional particularities of the geriatric management of Covid-19.