DGG publishes “COVID-19 in old age – The geriatric perspective”
17.03.2021 17:44
In the middle of the pandemic, society pays particular attention to the very elderly. They need to be protected. They need to be vaccinated first. After all, severe COVID-19 illnesses primarily affect the older population. Internationally, the mortality rate of hospitalized people over 80 was up to 54 percent in the first wave of the pandemic. Today, compared to the first data, only 13.4 percent of sick people over 80 years of age die, but mortality in this population group is still very high. “It is therefore imperative to look at this disease from a geriatric perspective,” says Professor Rainer Wirth, President-elect of the German Society for Geriatrics (DGG) and Director of the Clinic for Geriatric Medicine and Early Rehabilitation at the Marien Hospital Herne.
Wirth is the first author of the eight-page paper and coordinated its creation. “During the last few months, geriatrics, alongside intensive care medicine, has borne the brunt of the burden, but so far only relatively little has been heard or asked.” This should now change, especially among the specialist public, as a result of the paper.
The relevant scientific findings and recommendations have been published open access in the Journal of Gerontology and Geriatrics (ZGG). All six board members of the DGG as well as five other authors were involved in order to be able to shed light on all relevant aspects of COVID-19 disease in old age.
The most important questions and answers about Covid-19 in the very old
Why do older people in particular get sick? What are the special features of symptoms and progression in old age? What consequences can infection prophylactic measures have in the older population – this article provides answers. “The nine sub-areas contain a lot of important information for our colleagues,” says Wirth. “One year after the start of the pandemic, we were able to draw on extensive literature and thus convey the current state of knowledge.”
The DGG has specifically structured its paper into these areas:
1. Biological age and frailty
2. Treatment results and prognosis
3. Advance care planning
4. Therapeutic approaches, including intensive care
5. Neurological manifestations
6. Role of nutrition
7. Physical and psychological effects of quarantine and isolation measures
8. Need for rehabilitation
9. Vaccination and willingness to vaccinate
Adapt strategies for older people as needed
Diagnosis and treatment of COVID-19 disease in older patients does not fundamentally differ from younger patients. “However, atypical symptoms are more likely to occur in older patients,” says DGG Past President Professor Jürgen M. Bauer, head of the Center for Geriatrics at Heidelberg University Hospital. “A differentiated knowledge of the specific problems in the medical and nursing care of older people with Covid-19 is essential so that the relevant strategies can be adapted as needed.” Among other things, older patients are concerned with the functional and, in particular, the psychological effects of quarantine and isolation are more affected. The nutritional status of older patients is also of much greater importance in this context. “The early involvement of us geriatricians is important in order to adequately control the further course of treatment of the numerous very old COVID-19 patients,” says Bauer, who, with his experience for the DGG, also represents this position in the Pandemic Council of the German Medical Association.
“The article is a must for all healthcare workers around COVID-19!”
The conclusion of DGG President Professor Hans Jürgen Heppner, chief physician of the Department of Geriatrics at the HELIOS Klinikum Schwelm and chair of Geriatrics at the University of Witten/Herdecke: “The article is a must for all medical colleagues and employees in hospitals, nursing homes and doctor’s practices! Due to the pandemic, we are all constantly dealing with very old patients. It is important to us to shed more light on the needs and special characteristics of these patients.
The pandemic is already having a lasting impact on the social discussion on the topic of aging and geriatrics. “It is now up to all of us to improve the care of geriatric COVID-19 patients in the future!” said Heppner.