Elderly adults with COVID-19 admitted to intensive care unit: A narrative review

Gkoufa, Aikaterini; Maneta, Eleni; Ntoumas, Georgios; Georgakopoulou, Vasiliki; Mantelou, A.; Kokkoris, Stelios; Routsi, Christina

doi:10.5492/wjccm.v10.i5.278

Cited by 21 publications

(11 citation statements)

References 60 publications

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“…Some North American cohorts previously reported a fatality rate of 90% in patients older than 80 years on MV [ 32 , 33 ]. Other published cohorts usually reported lower, but still high, mortality [ 34 ]. Some cohorts have reported an inverse association between age and MV in COVID-19 patients, suggesting that there is an inherent bias towards less invasive treatment in these patients, regardless of the existence of clear limitation of treatment orders or not [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort

Andrei

Văleanu

Ştefan

et al. 2022

JCM

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Background. During the COVID-19 pandemic, resource allocation became a major problem in globally overwhelmed ICUs. The main goal of this study was to describe the clinical characteristics of the very elderly patients (aged ≥ 80 years) with COVID-19 admitted in Romanian ICUs. The study objectives were to evaluate and determine the factors associated with ICU mortality. Methods. We designed a national, multicentric, observational platform with prospective enrolment. This study included patients aged ≥ 80 years admitted in Romanian ICUs with SARS-CoV-2 infection from March 2020 to December 2021. Results. We included 1666 patients with a median age of 83 years and 78% ICU mortality. Male sex, dyspnoea, lower Glasgow Coma Scale and lower SpO2 at ICU admission, the need for mechanical ventilation (MV), and corticosteroid use were independently associated with mortality. A total of 886/1666 (53%) elderly patients underwent invasive mechanical ventilation, with a mortality of 97%. The age impact on mortality was confirmed by a 1:1 propensity matching with less elderly ICU patients. Conclusion. In extremely elderly patients with COVID-19 admitted in the ICU, mortality is high, particularly when requiring MV. Therapy should be directed towards the optimization of less invasive ventilatory methods and the use of MV and corticosteroids only in highly selected patients.

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Section: Discussionmentioning

confidence: 99%

Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort

Andrei

Văleanu

Ştefan

et al. 2022

JCM

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“…Early reports from China indicated a rise in the severity of sickness and death among persons aged 65 and older, and similar trends were seen in Europe, with mortality rates as high as 10% among adults aged 70, compared to 1% among young adults [ 24 , 25 ]. Compared to younger persons, elderly patients have a greater requirement for intensive care unit (ICU) admission and mechanical ventilation; hence, the SARS-CoV-2 infection increases the death risk among those aged 65 and older [ 26 , 27 ]. A subsequent meta-analysis supported these results, observing that almost half of older patients with COVID-19 have a severe infection, one in five are seriously sick, and one in ten will eventually die [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of FIB-4, NFS, APRI and Liver Function Tests as Predictors for SARS-CoV-2 Infection in the Elderly Population: A Matched Case-Control Analysis

Grigoraş

Citu

Cîtu

et al. 2022

JCM

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Several investigations have revealed that COVID-19 causes a significant death rate due to acute respiratory distress syndrome, alterations in the quantity of ACE2 receptor expression, or the intensity of cytokine storm. Similarly, patients with hepatic impairment that are co-infected with SARS-CoV-2 are more likely to display upregulations of ACE2 receptors and cytokine storm overload, which exacerbates hepatic impairment, potentially increasing the death rate. Moreover, it is expected that the aging population develops a higher degree of hepatic fibrosis in association with other comorbid conditions that are likely to influence the course of COVID-19. Therefore, this research was developed to describe the differences in liver test parameters in elderly individuals with COVID-19 in relation to other inflammatory markers and outcomes. This current observational single-center research followed a case-control design of elderly patients hospitalized for SARS-CoV-2 infection. The research was conducted at a tertiary emergency hospital in western Romania during a two-year period. There were 632 patients included in the analysis that were split into two equal groups matched 1:1 based on gender and body mass index. Three hundred sixteen patients made the group of cases with COVID-19 patients older than 65 years, while the other half were the 316 patient controls with COVID-19 that were younger than 65 years old. Disease outcomes showed a higher prevalence of ICU admissions (22.8% vs. 12.7%, p-value < 0.001) and in-hospital mortality (17.1% vs. 8.9%, p-value = 0.002) in the group of cases. Specific and non-specific liver biomarkers were identified as risk factors for mortality in the elderly, such as ALP (OR = 1.26), LDH (OR = 1.68), AST (OR = 1.98), and ALT (OR = 2.34). Similarly, patients with APRI and NFS scores higher than 1.5 were, respectively, 2.69 times and, 3.05 times more likely to die from COVID-19, and patients with FIB-4 scores higher than 3.25 were 3.13 times more likely to die during hospitalization for SARS-CoV-2 infection. Our research indicates that abnormally increased liver biomarkers and high liver fibrosis scores are related to a worse prognosis in SARS-CoV-2 infected individuals.

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“…5 A narrative review of 19 studies conducted in North America, Europe, and Asia among older patients with COVID-19 admitted to the ICU showed the rates of ICU admission in patients aged ≥60 years varied, with the highest rate being 79.6% and the highest ICU mortality rate being 91%. 8 Therefore, older adults should be prioritized in receiving COVID-19 vaccination to reduce mortality and morbidity.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccine Literacy, Attitudes, and Vaccination Intention Against COVID-19 Among Thai Older Adults

Kittipimpanon¹,

Maneesriwongul²,

Butsing³

et al. 2022

PPA

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Introduction Unvaccinated older adults with COVID-19 are at higher risk for severe illness and complications compared with those have been vaccinated. Vaccine literacy and attitudes are important factors that enhance healthy behaviors and choices, including vaccination intention. Objective To explore vaccine literacy, attitudes, and vaccination intention toward COVID-19 among Thai older adults and examine associations between vaccine literacy, attitudes, and vaccination intention. Methods This study used a cross-sectional online design. We surveyed 408 older adults who met our inclusion criteria. Participants were recruited online via social media and websites. The survey covered demographic data, vaccine literacy, attitudes, and intention to get the COVID-19 vaccine. Results COVID-19 vaccination intention among Thai older adults was high (81.3%). Females and those aged 60–69 years had higher COVID-19 vaccine literacy scores than males (t = −2.120, p < 0.05) and those aged ≥70 years (t = 2.438, p < 0.05). Participants with postgraduate education and those who were health professionals scored higher for vaccine literacy than less educated (t = −3.501, p < 0.01) and non-health professional (t = 5.437, p < 0.001) participants. Those with an adequate income or that had been vaccinated against COVID-19 scored significantly higher for vaccine literacy and attitudes toward the COVID-19 vaccine than participants with an inadequate income (t = 4.626, p < 0.001) or that had not been vaccinated (t = 2.842, p < 0.01). Vaccine literacy (r = 0.219, p < 0.001) and attitudes (r = 0.459, p < 0.001) were significantly associated with vaccination intention. Conclusion COVID-19 vaccine literacy and attitudes are significant factors related to vaccination intention. Health professionals could play an important role in enhancing vaccine literacy among older adults. Positive attitudes and COVID-19 vaccine literacy may enhance vaccination uptake in older adults.

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Elderly adults with COVID-19 admitted to intensive care unit: A narrative review

Cited by 21 publications

References 60 publications

Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort

Outcomes of COVID-19 Critically Ill Extremely Elderly Patients: Analysis of a Large, National, Observational Cohort

Evaluation of FIB-4, NFS, APRI and Liver Function Tests as Predictors for SARS-CoV-2 Infection in the Elderly Population: A Matched Case-Control Analysis

COVID-19 Vaccine Literacy, Attitudes, and Vaccination Intention Against COVID-19 Among Thai Older Adults

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