Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Sep 9, 2021; 10(5): 278-289
Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.278
Elderly adults with COVID-19 admitted to intensive care unit: A narrative review
Aikaterini Gkoufa, Eleni Maneta, Georgios N Ntoumas, Vasiliki E Georgakopoulou, Athina Mantelou, Stelios Kokkoris, Christina Routsi
Aikaterini Gkoufa, Vasiliki E Georgakopoulou, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece
Eleni Maneta, Georgios N Ntoumas, Athina Mantelou, Stelios Kokkoris, Christina Routsi, First Department of Intensive Care, School of Medicine, National and Kapodistrian University of Athens, Athens 10676, Greece
Author contributions: All authors contributed to this work with literature review, drafting, critical revision and editing, and approved the final version.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aikaterini Gkoufa, MD, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Agiou Thoma 17, Athens 11527, Greece. katergouf@yahoo.gr
Received: March 8, 2021
Peer-review started: March 8, 2021
First decision: June 5, 2021
Revised: June 19, 2021
Accepted: August 23, 2021
Article in press: August 23, 2021
Published online: September 9, 2021
Abstract
BACKGROUND

In the context of the Coronavirus disease 2019 (COVID-19) pandemic, it has been reported that elderly patients are particularly at risk of developing severe illness and exhibiting increased mortality. While many studies on hospitalized elderly patients with COVID-19 have been published, limited information is available on the characteristics and clinical outcomes of those elderly patients admitted to intensive care unit (ICU).

AIM

To review the available evidence of the clinical data of elderly patients admitted to the ICU due to COVID-19.

METHODS

We searched for published articles available in English literature to identify those studies conducted in critically ill patients admitted to the ICU due to COVID-19, either exclusively designed for the elderly or for the whole ICU population with COVID-19, provided that analyses according to the patients’ age had been conducted.

RESULTS

Only one study exclusively focusing on critically ill elderly patients admitted to the ICU due to COVID-19 was found. Eighteen additional studies involving 17011 ICU patients and providing information for elderly patients as a subset of the whole study population have also been included in the present review article. Among the whole patient population, included in these studies, 8310 patients were older than 65 years of age and 2630 patients were older than 70 years. Clinical manifestations were similar for all patients; however, compared to younger ones, they suffered from more comorbidities and showed a varied, albeit high mortality.

CONCLUSION

In summary, at present, although elderly patients constitute a considerable proportion of critically ill patients admitted to the ICU due to severe COVID-19, studies providing specific information are limited. The evidence so far suggests that advanced age and comorbidities are associated with worse clinical outcome. Future studies exclusively designed for this vulnerable group are needed.

Keywords: SARS-CoV-2, COVID-19, Elderly, Critically ill, Intensive care unit mortality, Respiratory failure

Core Tip: Coronavirus disease 2019 (COVID-19) affects people of all ages; however, the risk for severe illness increases with age, with older adults being at highest risk. While many studies with regard to COVID-19 impact on elderly patients have been carried out, the information on characteristics and clinical outcome of critically ill elderly patients admitted to the intensive care unit (ICU) due to COVID-19 is scarce. Studies exclusively designed for these patients are limited. Data derived from these studies and additionally from studies analyzing critically ill elderly patients as a subset of the whole ICU population with COVID-19, support that advanced age along with comorbidities are associated with worse clinical outcome.