COVID-19 in Older Adults

Coronavirus Disease 2019, commonly referred to as COVID-19, was first discovered in Wuhan, China, in late 2019. The illness, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread rapidly across six continents and represents the most significant global pandemic in over a century. The syndrome disproportionately affects older adults (OA), contributing to significant morbidity and mortality in this vulnerable population. In addition to the health consequences for millions of OA infected with SARS-CoV-2, countless more were impacted by disruptions to routine healthcare, caregiving, and social support systems. The ramifications of these disruptions continue to evolve and will impact the care for OA for years to come. COVID-19 affects a wide variety of organ systems and can have atypical clinical presentations in OA. This can affect the time to diagnosis and management. Additionally, COVID-19 treatment protocols have evolved since the start of the pandemic, and the development of novel vaccines have changed the scope of disease burden. There are unique challenges presented by COVID-19 in different care settings. Providers and health systems responded by developing innovative care models, some of which will change how healthcare is delivered to OA in the future. COVID-19 highlighted healthcare disparities that impacted health outcomes of older adults. We will review case studies to demonstrate the spectrum of illness and consequences of COVID-19. Management and understanding of COVID-19 will continue to evolve as we compile new data about the virus and our failures and successes in confronting a novel pandemic as geriatricians.