Oliba, Rome, Italy.
Catholic University of the Sacred Heart, Rome, Italy.
Aging Clin Exp Res. 2020 Jul;32(7):1189-1194. doi: 10.1007/s40520-020-01601-4. Epub 2020 May 26.
The early stages of the COVID-19 pandemic have focused on containing SARS-CoV-2 infection and identifying treatment strategies. While controlling this communicable disease is of utmost importance, the long-term effect on individuals with non-communicable diseases (NCD) is significant. Although certain NCDs appear to increase the severity of COVID-19 and mortality risk, SARS-CoV-2 infection in survivors with NCDs may also affect the progression of their pre-existing clinical conditions. Infection containment measures will have substantial short- and long-term consequences; social distancing and quarantine restrictions will reduce physical activity and increase other unhealthy lifestyles, thus increasing NCD risk factors and worsening clinical symptoms. Vitamin D levels might decrease and there might be a rise in mental health disorders. Many countries have made changes to routine management of NCD patients, e.g., cancelling non-urgent outpatient visits, which will have important implications for NCD management, diagnosis of new-onset NCDs, medication adherence, and NCD progression. We may have opportunities to learn from this unprecedented crisis on how to leverage healthcare technologies and improve procedures to optimize healthcare service provision. This article discusses how the COVID-19 outbreak and related infection control measures could hit the most frail individuals, worsening the condition of NCD patients, while further jeopardizing the sustainability of the healthcare systems. We suggest ways to define an integrated strategy that could involve both public institutional entities and the private sector to safeguard frail individuals and mitigate the impact of the outbreak.
在 COVID-19 大流行的早期阶段,重点是控制 SARS-CoV-2 感染并确定治疗策略。虽然控制这种传染病至关重要,但它对非传染性疾病(NCD)患者的长期影响也非常显著。虽然某些 NCD 似乎会增加 COVID-19 的严重程度和死亡风险,但 SARS-CoV-2 感染也可能影响 NCD 幸存者先前存在的临床状况的进展。感染控制措施将产生重大的短期和长期后果;社交距离和隔离限制将减少身体活动并增加其他不健康的生活方式,从而增加 NCD 风险因素并加重临床症状。维生素 D 水平可能会降低,心理健康障碍可能会增加。许多国家已经对 NCD 患者的常规管理进行了调整,例如取消非紧急门诊就诊,这将对 NCD 管理、新发 NCD 的诊断、药物依从性和 NCD 进展产生重要影响。我们可能有机会从这场前所未有的危机中吸取教训,了解如何利用医疗保健技术并改进程序,以优化医疗保健服务的提供。本文讨论了 COVID-19 疫情及其相关感染控制措施如何影响最脆弱的人群,使 NCD 患者的病情恶化,同时进一步危及医疗保健系统的可持续性。我们建议定义一种综合战略的方法,该战略可以涉及公共机构实体和私营部门,以保护脆弱人群并减轻疫情的影响。