J. Gerontol. Geriatr., Volume 68, Issue 4 (December 2020) – 8 articles , Pages 197-242

The coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is responsible for the coronavirus disease 2019 (COVID-19), is known to cause substantial pulmonary disease. However, clinicians observed many extrapulmonary manifestations of COVID-19. Neurological manifestations are being recognised increasingly. On the basis of knowledge of other coronaviruses, especially those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome epidemics, cases of central nervous system disease caused by SARS-CoV-2 might be expected to be rare. We report four cases of neurologic manifestations of SARS-CoV-2 in elderly patients who presented to the Geriatric Department of Pescara Hospital (Italy). Full article

We report on a case of SARS-CoV-2-infected patient with clinical and histologic features mimicking ischaemic colitis. This case provides evidence that SARS-CoV-2 may compromise the microvascular blood flow in the intestinal wall, with a parallel activation of the inflammatory cascade, either in the absence, or earlier of any pulmonary involvement. Full article

The World Health Organization (WHO) has declared COVID-19 disease a public health emergency of international concern. Even though no age-group is safe from the SARS-CoV-2 infection, the burden is extremely higher and most severe among persons aged 70 years and over, with a well-known mortality rates of more than 20% among octogenarians. The presence of multiple pre-existing comorbidities is associated with more severe SARS-CoV-2 infection manifestation, reflecting the presence of pre-existent physical and/or cognitive frailty. One of the main problems in patients with cognitive disorders is the management of drug therapy. In fact, there are a number of interactions and contraindications in the simultaneous administration of the antiviral drugs and the drugs that are commonly taken by older people. The aim of this review is to provide a clear and simple indication on how to improve the pharmacological and non-pharmacological management of patients with dementia and at the same time suffering from COVID-19 disease. Full article

Background. On March 2020, WHO declares the world pandemic by COVID-19. In this report we report the COVID-19 infection, related to male gender, comorbidity and special population. Data resources. We describe the published studies by PubMed, Medscape and Scopus between December 2019 to May 2020. Keywords used: male/man gender, sex differences, COVID-19, comorbidity, diabetes, hypertension, elderly, pregnancy, children. Results. The elderly population and infants are a population at higher risk. The comorbidities are risk factors for the development of a more severe form of disease. There may be a sex predisposition to COVID-19 infection, with men more prone to be affected. 83.9% of COVID-19 patients with chronic kidney disease (CKD) and 57.3% of COVID-19 patients with liver diseases, have a severe disease. Conclusions. Older age, infants, male gender and comorbidity describe a crucial role for severity of COVID-19 disease. Future studies are need for the management of these patients. Full article

On June 2020, many professional soccer athletes of Italian teams re-started playing League A. Some of them recovered from COVID-19, resumed their sports at a competitive level declaring to have struggled for a long time during recovering period. Most COVID-19 survivors (especially older people) are not professional athletes; these persons cannot generally benefit from a dedicated staff during recovery. This is why it is really important to provide rehabilitation and physical exercise protocols for adults and/or older people who have recovered from COVID-19. To this aim, the post-COVID-19 service of Fondazione Policlinico Universitario A. Gemelli (Rome, Italy) has developed specific physical activity programmes. The physical activity protocol of “SPRINTT”, a European project aimed at preventing mobility disability in frail older people with sarcopenia, has been re-shaped to adapt it to COVID-19 survivors. This personalized program includes aerobic, strength, flexibility, and balance training. Accumulating evidence supports regular physical activity, in combination with appropriate nutritional support, as the most effective strategy for improving sarcopenia and physical function. More studies are needed to determine if this may be more valid in COVID1-19 patients. Full article

Objectives. Clinical evidence suggests that the COVID-19 disease is more severe in the endangered populations. The purpose of this study was to investigate knowledge, attitude and practice of older people in Iran toward COVID-19 disease as a high risk group. Methods. A cross sectional study of 249 older people was conducted, using a researcher-made questionnaire. Data analysis was performed using descriptive and analytical statistics, using generalized linear model using the Gamma probability distribution model. Results. Mean scores of knowledge, attitude and practice of the older people were 92.3 ± 10.8, 89.1 ± 14.3 and 90.4 ± 13.4 respectively and were not significantly different from the sex and history of underlying diseases (p > 0.05). At generalized linear model there were no significant relationship between the older people age and their mean scores of knowledge (p > 0.05), but significant relationship between level of education and knowledge score (p < 0.001) and age and attitude, and age and practice (p < 0.5), adjusted for age > 80 years. Conclusions. This study is among the first to assess knowledge, attitudes and practice of older people toward the COVID-19 pandemic in Iran. The results indicated that the general education about the disease and follow-up of responsible organizations has been effective and these interventions need to continue. Full article

Background. The mortality rate for coronavirus disease-19 (COVID-19) increases with age. Some anti-inflammatory drugs such as tocilizumab or steroids have been proposed for the treatment of severe disease; however, few data are available in the elderly. Methods. A retrospective case-series of patients hospitalized between March 1st and June 15^th, 2020 with confirmed COVID-19 by RT-PCR testing on throat/nasopharyngeal swabs and age ≥ 65 years was analysed. Patients were retrospectively divided into three groups according to the chosen treatment [standard of care (SOC), tocilizumab or corticosteroids] and patient characteristics and occurrence of adverse events were compared among groups. Results. Overall, 206 patients were included, 148 treated with standard of care, 42 with steroids and 16 with tocilizumab. Patients treated with steroids or Tocilizumab presented more frequently with fever (p = .003), dyspnea (p < .001), bilateral opacities/infiltrates at chest X-ray (p =.026) or CT-scan (p = .020), and more frequently required non-invasive/invasive ventilation (p < .001). Crude mortality was 27%, without differences among groups (p = .074). No specific adverse events were observed during/after the administration of steroids or tocilizumab; however, a trend towards an increased risk of secondary infections was described compared to SOC (p = .097). At multivariate logistic regression, only tocilizumab administration was an independent predictor of secondary infections (aOR = 6.72, 95% CI = 1.43-31.39, p = .015). Conclusions. Tocilizumab and corticosteroid could have a possible role for severe form of pneumonia in course of COVID-19 also in elderly patients, even if great attention to the monitoring of infectious complications should be paid in this special population. Full article