Cargando…
Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications
Covid-19 infection is a multisystem disease more frequent in older individuals, especially in those with multiple chronic diseases. This multimorbid and frail population requires attention and a personalized comprehensive assessment in order to avoid the occurrence of adverse outcomes. As other dise...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mattioli 1885
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569659/ https://www.ncbi.nlm.nih.gov/pubmed/32420939 http://dx.doi.org/10.23750/abm.v91i2.9629 |
_version_ | 1783596775190298624 |
---|---|
author | Lauretani, Fulvio Ravazzoni, Giulia Roberti, Maria Federica Longobucco, Yari Adorni, Elisa Grossi, Margherita De Iorio, Aurelio La Porta, Umberto Fazio, Chiara Gallini, Elena Federici, Raffaele Salvi, Marco Ciarrocchi, Erika Rossi, Francesca Bergamin, Marina Bussolati, Giacomo Grieco, Ilaria Broccoli, Federica Zucchini, Irene Ielo, Giuseppe Morganti, Simonetta Artoni, Andrea Arisi, Arianna Tagliaferri, Sara Maggio, Marcello |
author_facet | Lauretani, Fulvio Ravazzoni, Giulia Roberti, Maria Federica Longobucco, Yari Adorni, Elisa Grossi, Margherita De Iorio, Aurelio La Porta, Umberto Fazio, Chiara Gallini, Elena Federici, Raffaele Salvi, Marco Ciarrocchi, Erika Rossi, Francesca Bergamin, Marina Bussolati, Giacomo Grieco, Ilaria Broccoli, Federica Zucchini, Irene Ielo, Giuseppe Morganti, Simonetta Artoni, Andrea Arisi, Arianna Tagliaferri, Sara Maggio, Marcello |
author_sort | Lauretani, Fulvio |
collection | PubMed |
description | Covid-19 infection is a multisystem disease more frequent in older individuals, especially in those with multiple chronic diseases. This multimorbid and frail population requires attention and a personalized comprehensive assessment in order to avoid the occurrence of adverse outcomes. As other diseases, the COVID-19 presentation in older patients is often atypical with less severe and unspecific symptoms. These subjects both at home and during hospitalization suffer isolation and the lack of support of caregivers. The geriatric care in COVID-19 wards is often missing. The application of additional instruments would be necessary to facilitate and personalize the clinical approach, not only based on diseases but also on functional status. This narrative review starts from diagnostic evaluation, continues with adapted pharmacologic treatment and ends with the recovery phase targeting the nutrition and physical exercise. We developed a check-list of respiratory, gastro-intestinal and other less-specific symptoms, summarized in a table and easily to be filled-up by patients, nurses and general practitioners. As second step, we reported the clinical phases of this disease. Far to be considered just viral infective and respiratory, this disease is also an inflammatory and thrombotic condition with frequent bacterial over-infection. We finally considered timing and selection of treatment, which depend on the disease phase, co-administration of other drugs and require the monitoring of renal, liver and cardiac function. This underlines the role of age not just as a limitation, but also an opportunity to increase the quality and the appropriateness of multidisciplinary and multidimensional intervention in this population. (www.actabiomedica.it) |
format | Online Article Text |
id | pubmed-7569659 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Mattioli 1885 |
record_format | MEDLINE/PubMed |
spelling | pubmed-75696592020-10-21 Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications Lauretani, Fulvio Ravazzoni, Giulia Roberti, Maria Federica Longobucco, Yari Adorni, Elisa Grossi, Margherita De Iorio, Aurelio La Porta, Umberto Fazio, Chiara Gallini, Elena Federici, Raffaele Salvi, Marco Ciarrocchi, Erika Rossi, Francesca Bergamin, Marina Bussolati, Giacomo Grieco, Ilaria Broccoli, Federica Zucchini, Irene Ielo, Giuseppe Morganti, Simonetta Artoni, Andrea Arisi, Arianna Tagliaferri, Sara Maggio, Marcello Acta Biomed Reviews/Focus on Covid-19 infection is a multisystem disease more frequent in older individuals, especially in those with multiple chronic diseases. This multimorbid and frail population requires attention and a personalized comprehensive assessment in order to avoid the occurrence of adverse outcomes. As other diseases, the COVID-19 presentation in older patients is often atypical with less severe and unspecific symptoms. These subjects both at home and during hospitalization suffer isolation and the lack of support of caregivers. The geriatric care in COVID-19 wards is often missing. The application of additional instruments would be necessary to facilitate and personalize the clinical approach, not only based on diseases but also on functional status. This narrative review starts from diagnostic evaluation, continues with adapted pharmacologic treatment and ends with the recovery phase targeting the nutrition and physical exercise. We developed a check-list of respiratory, gastro-intestinal and other less-specific symptoms, summarized in a table and easily to be filled-up by patients, nurses and general practitioners. As second step, we reported the clinical phases of this disease. Far to be considered just viral infective and respiratory, this disease is also an inflammatory and thrombotic condition with frequent bacterial over-infection. We finally considered timing and selection of treatment, which depend on the disease phase, co-administration of other drugs and require the monitoring of renal, liver and cardiac function. This underlines the role of age not just as a limitation, but also an opportunity to increase the quality and the appropriateness of multidisciplinary and multidimensional intervention in this population. (www.actabiomedica.it) Mattioli 1885 2020 2020-05-11 /pmc/articles/PMC7569659/ /pubmed/32420939 http://dx.doi.org/10.23750/abm.v91i2.9629 Text en Copyright: © 2020 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA http://creativecommons.org/licenses/by-nc-sa/4.0 This work is licensed under a Creative Commons Attribution 4.0 International License |
spellingShingle | Reviews/Focus on Lauretani, Fulvio Ravazzoni, Giulia Roberti, Maria Federica Longobucco, Yari Adorni, Elisa Grossi, Margherita De Iorio, Aurelio La Porta, Umberto Fazio, Chiara Gallini, Elena Federici, Raffaele Salvi, Marco Ciarrocchi, Erika Rossi, Francesca Bergamin, Marina Bussolati, Giacomo Grieco, Ilaria Broccoli, Federica Zucchini, Irene Ielo, Giuseppe Morganti, Simonetta Artoni, Andrea Arisi, Arianna Tagliaferri, Sara Maggio, Marcello Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications |
title | Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications |
title_full | Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications |
title_fullStr | Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications |
title_full_unstemmed | Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications |
title_short | Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications |
title_sort | assessment and treatment of older individuals with covid-19 multi-system disease: clinical and ethical implications |
topic | Reviews/Focus on |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569659/ https://www.ncbi.nlm.nih.gov/pubmed/32420939 http://dx.doi.org/10.23750/abm.v91i2.9629 |
work_keys_str_mv | AT lauretanifulvio assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT ravazzonigiulia assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT robertimariafederica assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT longobuccoyari assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT adornielisa assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT grossimargherita assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT deiorioaurelio assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT laportaumberto assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT faziochiara assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT gallinielena assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT federiciraffaele assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT salvimarco assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT ciarrocchierika assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT rossifrancesca assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT bergaminmarina assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT bussolatigiacomo assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT griecoilaria assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT broccolifederica assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT zucchiniirene assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT ielogiuseppe assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT morgantisimonetta assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT artoniandrea assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT arisiarianna assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT tagliaferrisara assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications AT maggiomarcello assessmentandtreatmentofolderindividualswithcovid19multisystemdiseaseclinicalandethicalimplications |