Stellungnahme der AG pneumologische Altersmedizin zu COVID-19 bei geriatrischen Patienten

 

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Die epidemiologischen Daten zeigen weltweit, dass von schweren Verläufen und Todesfällen mehrheitlich alte Patienten betroffen sind und die Case Fatality Rate ab einem Alter von 65 Jahren deutlich ansteigt [1]. Die Sterblichkeit bei Patienten über 80 Jahre liegt bei über 15 % [2]. Dies macht COVID-19 zu einer gerontopneumologischen Erkrankung. Die AG pneumologische Altersmedizin gibt im Folgenden daher eine Stellungnahme zur Therapie geriatrischer Patienten mit COVID-19. Diese ist als Ergänzung zu Empfehlungen anderer Arbeitsgruppen zu verstehen.

Publication History

Article published online:
20 May 2020

© Georg Thieme Verlag KG
Stuttgart · New York

• Literatur

• 1 Zhu N, Zhang D, Wang W. China Novel Coronavirus Investigating and Research Team. et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382: 727-733 DOI: 10.1056/NEJMoa2001017.
  CrossrefPubMedGoogle Scholar
• 2 Zhou F, Yu T, Du R. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-1062 DOI: 10.1016/S0140-6736(20)30566-3.
  CrossrefPubMedGoogle Scholar
• 3 Bernheim A, Mei X, Huang M. et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology 2020; DOI: 10.1148/radiol.2020200463.
  CrossrefPubMedGoogle Scholar
• 4 Chung M, Bernheim A, Mei X. et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology 2020; 295: 202-207 DOI: 10.1148/radiol.2020200230.
  CrossrefPubMedGoogle Scholar
• 5 Fang Y, Zhang H, Xie J. et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology 2020; DOI: 10.1148/radiol.2020200432.
  CrossrefPubMedGoogle Scholar
• 6 Stieglitz S. Gerontopneumologie: Herausforderungen, Tipps und Tricks. Deutsche Ärzteblatt 2019; 116: [19] DOI: 10.3238/PersPneumo.2019.02.15.003.
  CrossrefPubMedGoogle Scholar
• 7 Deiner S, Fleisher LA, Leung JM. et al., Anesthesia ASACoG. the ASAPBHIAdherence to recommended practices for perioperative anesthesia care for older adults among US anesthesiologists: results from the ASA Committee on Geriatric Anesthesia-Perioperative Brain Health Initiative ASA member survey. Perioper Med (Lond) 2020; 9: 6 DOI: 10.1186/s13741-020-0136-9.
  CrossrefPubMedGoogle Scholar
• 8 Zeng A, Song X, Dong J. et al. Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit. J Gerontol A Biol Sci Med Sci 2015; 70: 1586-1594 DOI: 10.1093/gerona/glv084.
  CrossrefPubMedGoogle Scholar
• 9 Rockwood K, Song X, MacKnight C. et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489-495 DOI: 10.1503/cmaj.050051.
  CrossrefPubMedGoogle Scholar
• 10 Danser AHJ, Epstein M, Batlle D. Renin-Angiotensin System Blockers and the COVID-19 Pandemic: At Present There Is No Evidence to Abandon Renin-Angiotensin System Blockers. Hypertension 2020; DOI: 10.1161/HYPERTENSIONAHA.120.15082.
  CrossrefPubMedGoogle Scholar
• 11 Shahid Z, Kalayanamitra R, McClafferty B. et al. COVID-19 and Older Adults: What We Know. J Am Geriatr Soc 2020; DOI: 10.1111/jgs.16472.
  CrossrefPubMedGoogle Scholar
• 12 Scala R, Ciarleglio G, Maccari U. et al. Ventilator Support and Oxygen Therapy in Palliative and End-of-Life Care in the Elderly. Turk Thorac J 2020; 21: 54-60 DOI: 10.5152/TurkThoracJ.2020.201401.
  CrossrefPubMedGoogle Scholar
• 13 Tang N, Bai H, Chen X. et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020; DOI: 10.1111/jth.14817.
  CrossrefPubMedGoogle Scholar
• 14 Gattinoni L, Coppola S, Cressoni M. et al. Covid-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 2020; DOI: 10.1164/rccm.202003-0817LE.
  CrossrefPubMedGoogle Scholar
• 15 Kluge S, Janssens U, Welte T. et al. Recommendations for critically ill patients with COVID-19. Med Klin Intensivmed Notfmed 2020; 115 : 175-177 DOI: 10.1007/s00063-020-00674-3.
  CrossrefPubMedGoogle Scholar
• 16 Pierson DJ. Indications for mechanical ventilation in adults with acute respiratory failure. Respir Care 2002; 47: 249-262; discussion 262–245
  PubMedGoogle Scholar
• 17 Skytioti M, Sovik S, Elstad M. Respiratory pump maintains cardiac stroke volume during hypovolemia in young, healthy volunteers. J Appl Physiol (1985) 2018; 124: 1319-1325 DOI: 10.1152/japplphysiol.01009.2017.
  CrossrefPubMedGoogle Scholar
• 18 Taboada M, Doldan P, Calvo A. et al. Comparison of Tracheal Intubation Conditions in Operating Room and Intensive Care Unit: A Prospective, Observational Study. Anesthesiology 2018; 129: 321-328 DOI: 10.1097/ALN.0000000000002269.
  CrossrefPubMedGoogle Scholar
• 19 COVID-19 Guidelines. SCCM; 2020 https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/COVID-19 Accessed: 11.05.2020
  PubMedGoogle Scholar
• 20 Ding L, Wang L, Ma W. et al. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study. Crit Care 2020; 24: 28 DOI: 10.1186/s13054-020-2738-5.
  CrossrefPubMedGoogle Scholar
• 21 Nehls W, Delis S, Haberland B. et al. Management of Patients with COVID-19 - Recommendations from a Palliative Care Perspective. Pneumologie 2020; DOI: 10.1055/a-1156-2759.
  Article in Thieme ConnectPubMedGoogle Scholar