Download PDF
Dtsch Med Wochenschr 2020; 145(15): 1039-1043
DOI: 10.1055/a-1164-4261
Dossier

COVID-19 aus Sicht der Geriatrie

COVID-19: a geriatric point-of-view
Cornel Sieber
› Further Information
Also available at
    Permissions and Reprints

Abstract

The pandemic due to the SARS-CoV-2 virus challenges all of us in the many areas of life. Our health systems are tested for their sustainability and load capacity. SARS-CoV-2 virus-infections will become part of our lives, but they mainly threaten vulnerable and multimorbid older adults. Older people with a frailty-syndrome are challenged not only in physical, but also psychological and social domains. Adapted caring structures are required and the pandemic will introduce important ethical discussions. As examples, distribution of limited resources, requests for more Advance Care Planning as well as balancing between infection protection versus the drawbacks of long-lasting social isolation should be named. This article therefore focuses on ethical questions for older adults in times of the SARS-CoV-2 virus pandemic.

Die SARS-CoV-2-Virusinfektion bedroht ganz speziell vulnerable, meist multimorbide ältere Menschen, die nicht nur physisch, sondern auch psychisch und sozial betroffen sind. Dies erfordert eine angepasste Veränderung der Betreuungsstrukturen und damit den Umgang mit limitierten Ressourcen, mehr Advance Care Planning und die Abwägung zwischen Infektionsschutz vs. den Gefahren langfristiger sozialer Isolation.

Schlüsselwörter

Corona-Pandemie - SARS-CoV-2 - COVID-19 - Geriatrie - Immunoseneszenz - Multimorbidität - intrinsische Kapazität - Ethik

Key words

Corona-pandemic - SARS-CoV-2 virus - COVID-19 - geriatrics - immunosenescence - multimorbidity - intrinsic capacity - ethics


Publication History

Article published online:
30 July 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA 2020; 323 (13) 1239-1242 . doi:10.1001/jama.2020.2648
    CrossrefPubMedGoogle Scholar
  • 2 Livingston E, Bucher K. Coronavirus disease 2019 – COVID-19 in Italy. JAMA 2020; 323 (14) 1335 . doi:10.1001/jama.2020.4344
    CrossrefPubMedGoogle Scholar
  • 3 Centers for Disease Control and Prevention (CDC). Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) – United States, February 12–March 16. 2020 Im Internet: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm; Stand: 16.06.2020
    PubMedGoogle Scholar
  • 4 Lithander FE, Neumann S, Tenison E. et al. COVID-19 in older people: a rapid clinical review. Age and Ageing 2020; 1-15 DOI: org/10.1093/ageing/afaa093.
    CrossrefPubMedGoogle Scholar
  • 5 Deutsche Akademie der Naturforscher Leopoldina e. V. – Nationale Akademie der Wissenschaften. Im Internet (Stand: 16.06.2020): www.leopoldina.org
    PubMedGoogle Scholar
  • 6 Hoffmann U, Sieber CC. Is age a comorbidity?. Dtsch Med Wochenschr 2017; 142: 1030-1036
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Battegay E, Cheetham M, Holzer BM. et al. Multimorbidity management and the physician’s daily clinical dilemma. Internist 2017; 58: 344-353
    CrossrefPubMedGoogle Scholar
  • 8 Fried LP, Tangen CM, Walston J. et al. Cardiovascular Health Study Collaborative Research Group. J Gerontol A Biol Sci Med Sci 2001; 56: M146-M156
    CrossrefPubMedGoogle Scholar
  • 9 Theou O, Squires E, Mallery K. et al What do we know about frailty in the acute care setting? A scoping review. BMC Geriatr 2018; 18 (01) 139 . doi 10.1186/s12877-018-0823-2
    CrossrefPubMedGoogle Scholar
  • 10 Beard DR, Jotheeswaran AT, Cesari M. et al The structure and predictive value of intrinsic capacity in a longitudinal study of ageing. BMJ Open 2019; 9 (11) e026119 . doi:10.1136/bmjopen-2018-026119
    CrossrefPubMedGoogle Scholar
  • 11 Kojima G. Prevalence of frailty in nursing homes: A systematic review and meta-analysis. J Am Med Dir Assoc 2015; 16: 940-945
    CrossrefPubMedGoogle Scholar
  • 12 Huang YM, Hong XZ, Shern J. et al China’s oldest coronavirus survivors. J Am Geriatr Soc 2020; 68 (05) 940-942 . doi:dx.doj.org/10.1111/jgs.16462
    CrossrefPubMedGoogle Scholar
  • 13 Rockwood K, Sung X, MacKnight C. et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489-495
    CrossrefPubMedGoogle Scholar
  • 14 Hubbard RE, Maier AB, Hilmer SN. et al Frailty in the face of COVID-19. Age and Ageing 2020; 00: 1-2 . doi:org/10.1093/ageing/afaa095
    PubMedGoogle Scholar
  • 15 Zeeh J, Memm K, Heppner HJ. et al. Beatmung geriatrischer Patienten – ein ethisches Dilemma?. MMW Fortschr Med 2020; 162: 40-45
    CrossrefPubMedGoogle Scholar
  • 16 Sieber CC. Patient-oriented medicine in the elderly. Internist 2017; 58: 354-358
    CrossrefPubMedGoogle Scholar
  • 17 Nickel CH, Bingisser R. Mimics and chameleons of COVID-19. Swiss Med Wkly 2020; 150: w20231 . doi:dx.doi.org/10.4414/smw.2020.20231
    PubMedGoogle Scholar
  • 18 Hofman MR, van den Hanenberg F, Sierevelt IN. et al. Elderly patients with atypical presentation of illness in the emergency department. Neth J Med 2020; 75: 241-246
    PubMedGoogle Scholar
  • 19 Aiello A, Forzaneh F, Candore G. et al Immunosenescence and its hallmarks: how to oppose aging strategically? A review of potential options for therapeutic intervention. Front Immunol 2019; 10: 2247 . doi:10.3389/fimmu.2019.02247
    CrossrefPubMedGoogle Scholar
  • 20 Smetana J, Chlibek R, Shaw W. et al. Influenza vaccination in the elderly. Hum Vaccin Immunother 2018; 14: 540-549
    CrossrefPubMedGoogle Scholar
  • 21 Schlögl M, Jones CA. Maintaining our humanity through the mask: mindful communication during COVID-19. J Am Geriatr Soc 2020; 68 (05) E12-E13
    PubMedGoogle Scholar
  • 22 Wakam GK, Montgomery JR, Biesterveld BE. et al Not dying alone – modern compassionate care in the COVID-19 pandemic. N Engl J Med 2020; 382: e88 . doi:10.1056/NEJMp2007781
    CrossrefPubMedGoogle Scholar
  • 23 Hollander JE, Carr BG. Virtually perfect? Telemedicine for COVID-19. N Engl J Med 2020; 382: 1679-1681 . doi:10.1056/NEJMp2003539
    Google Scholar
  • 24 Borasio GD, Gamondi C, Obrist M. et al. COVID-19: decision making and palliative care. Swiss Med Wkly 2020; 150: w20233
    PubMedGoogle Scholar
  • 25 Wallace CL, Wladkowski SP, Gibson A. et al. Grief during the COVID-19 pandemic: considerations for palliative care providers. J Pain Symptom Manag 2020; S08853924 (20) 30207-4
    PubMedGoogle Scholar
  • 26 Statement of the EuGMS Executive Board on the COVID-19 epidemic. Im Internet (Stand: 16.06.2020): http://www.eugms.org/news/read/article/489.html
    PubMedGoogle Scholar
  • 27 Boreskie KF, Boreskie PE, Melady D. Age is just a number – and so is frailty: Strategies to inform resource allocation during the COVID-19 pandemic. CJEM 2020; 1-3 DOI: 10.1017/cem.2020.358.
    CrossrefPubMedGoogle Scholar
  • 28 Montero-Odasso M, Goens SD, Kamkar N. et al. Canadian Geriatrics Society COVID-19 recommendations for older adults. What do older adults need to know?. Can Geriatr J 2020; 23: 149-151
    PubMedGoogle Scholar
  • 29 Williams DR, Cooper LA. COVID-19 and health equity – a new kind of „herd immunity“. Published online May 2020 DOI: 10.1001/jama.2020.8051.
    CrossrefPubMedGoogle Scholar