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Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2022; 10(23): 8088-8096
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8088
Beta receptor blocker therapy for the elderly in the COVID-19 era
Elpidio Santillo, Monica Migale
Elpidio Santillo, Monica Migale, Geriatric Rehabilitative Department, IRCCS-INRCA, Fermo 63900, Italy
Author contributions: Santillo E performed the majority of the writing, prepared the figure and table, designed the outline, and coordinated the writing of the paper; Migale M performed the data acquisition and initial writing, and provided input in subsequent drafts of the paper; both authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Elpidio Santillo, MD, PhD, Staff Physician, Geriatric Rehabilitative Department, IRCCS-INRCA, C.da Mossa 2, Fermo 63900, Italy. elpisant@tin.it
Received: April 6, 2022
Peer-review started: April 6, 2022
First decision: June 16, 2022
Revised: June 26, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 16, 2022
Abstract

When the coronavirus disease 2019 (COVID-19) pandemic spread globally from the Hubei region of China in December 2019, the impact on elderly people was particularly unfavorable. The mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was highest in older individuals, in whom frailty and comorbidities increased susceptibility to severe forms of COVID-19. Unfortunately, in older patients, the course of COVID-19 was often characterized by significant cardiovascular complications, such as heart failure decompensation, arrhythmias, pericarditis, and myopericarditis. Ensuring that the elderly have adequate therapeutic coverage against known cardiovascular diseases and risk factors is particularly important in the COVID-19 era. Beta blockers are widely used for the treatment and prevention of cardiovascular disease. The clinical benefits of beta blockers have been confirmed in elderly patients, and in addition to their negative chronotropic effect, sympathetic inhibition and anti-inflammatory activity are theoretically of great benefit for the treatment of COVID-19 infection. Beta blockers have not been clearly shown to prevent SARS-CoV-2 infection, but there is evidence from published studies including elderly patients that beta blockers are associated with a more favorable clinical course of COVID-19 and reduced mortality. In this minireview, we summarize the most important evidence available in the literature on the usefulness of beta blocker therapy for older patients in the context of the COVID-19 pandemic.

Keywords: Adrenergic beta-antagonist, COVID-19, Aged, SARS-CoV-2, Cardiovascular diseases

Core Tip: This minireview offers an original and innovative summary of recent studies of the usefulness of beta blocker therapy for the elderly in the coronavirus disease 2019 (COVID-19) pandemic. We discuss the pharmacologic benefits of beta blocker therapy for older subjects and report the results of early studies highlighting the favorable effects of beta blockers on elderly patients affected by COVID-19.