All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
Horm Mol Biol Clin Investig. 2021 Feb 4;42(1):87-98. doi: 10.1515/hmbci-2020-0053.
The COVID-19 pandemic has not only led to a worldwide socio-economic depression, but has also had the highest health impact on the geriatric population. Elderly population, due to various reasons such as low immunity, pre-existing co-morbidities such as hypertension, cardiovascular diseases or diabetes, are obviously predisposed to develop severe infections and exhibit a high mortality rate. This is because of many reasons which include the atypical presentation in the geriatric population which might have led to diagnostic delay. As per the WHO guidelines to perform RT-PCR only on the symptomatic individuals, a very small portion of individuals were tested, leaving a fraction of population undiagnosed. Therefore, there remained a chance that many asymptomatic individuals such caregivers, healthcare professionals, family members were undiagnosed and might have carried this virus to the geriatric patients. Also, many countries were not prepared to handle the burden on their healthcare system which included sudden increased demand of ICU beds, mechanical ventilation etc. As a result, they had to make decision on who to be admitted. Atypical presentation in geriatric population may include afebrile or low-grade fever, absence of cough, malaise, muscle pains, dyspnoea etc. Geriatric population shows a more severe type of pneumonia, significantly higher number of neutrophils and C-reactive protein, less lymphocytes and a higher proportion of multiple lobe involvement. Extreme social suppression during COVID-19 pandemic has increased the risk of mental and physical adverse effects that has made older adults more vulnerable to depression and anxiety.
COVID-19 大流行不仅导致了全球社会经济萧条，而且对老年人群体造成了最大的健康影响。老年人群体由于免疫力低下、存在高血压、心血管疾病或糖尿病等合并症等各种原因，显然更容易发生严重感染，并表现出高死亡率。这是由于许多原因，包括老年人群体中不典型的表现可能导致诊断延迟。根据世界卫生组织的指南，仅对有症状的个体进行 RT-PCR 检测，只有一小部分个体接受了检测，使一部分人群未被诊断。因此，许多无症状个体（如护理人员、医护人员、家庭成员）仍有可能未被诊断出来，并可能将病毒传播给老年患者。此外，许多国家还没有准备好应对医疗保健系统的负担，包括 ICU 床位、机械通气等需求的突然增加。因此，他们不得不决定谁可以入院。老年人群体中不典型的表现可能包括无热或低热、无咳嗽、不适、肌肉疼痛、呼吸困难等。老年人群体表现出更严重的肺炎类型，中性粒细胞和 C 反应蛋白数量显著增加，淋巴细胞数量减少，多叶受累的比例更高。COVID-19 大流行期间的极端社交抑制增加了心理和身体不良影响的风险，使老年人更容易患抑郁症和焦虑症。
