BookNicola Vargas, Antonio M. Esquinas, editors.
Summary: This book describes the issues and challenges that clinicians encountered in the management of older critically ill patients during the Covid-19 pandemic, and offers practical information on how to manage them. Older adults are more susceptible to complications such as acute respiratory distress syndrome (ARDS) as a result of viral pneumonia. In addition, they often have multiple comorbidities and are commonly frail, which means their various organs and systems, such as the respiratory system, have reduced functional reserves. As such, older adults are less able to react to acute stressors. During the current Covid-19 pandemic, older adult patients' mortality is increased. Further, the infection and death rates of elderly people in nursing homes and health care institutions are high. Management of older adults with Covid is complicated. The reduced availability of beds may limit their access to ICU. Moreover, the prognosis may be poor, and airway management and ventilation strategies have to take into account various clinical and physiological characteristics specific to older patients. This book is addressed to all allied professionals involved in the management of older critically ill patients and presents information collected and practical lessons learned from the clinical daily management of this population during the pandemic.
Contents:
Intro
Preface
Contents
Part I: Epidemiology
1: Mortality and Prognosis of Older Patients During COVID-19 Pandemic
1.1 Epidemiological Perspective: A Global View of the Problem
1.2 Why the Elderly Is at Higher Risk? A Pathophysiological View
1.3 Prognosis of the COVID-19 Elderly Patient
References
2: Elderly Pneumonia COVID-19 Cases: Impact on the Outcome
2.1 Introduction
2.2 Acute Complications Associated with COVID-19 Pneumonia in Elderly
2.3 Elderly Mortality Rate for COVID-19 Disease
2.4 Conclusion
References 3: Incidence of ARF Due to COVID-19 Interstitial Pneumonia
References
4: Changing the Demographics in ICU During COVID-19 Pandemic
4.1 Pre-COVID-19 Epidemy Demographic Aspects in ICU
4.2 Demographic Aspects During the COVID-19 Outbreak in ICU
4.3 Comparison between H1N1 and COVID-19 Epidemy
4.4 Conclusions
References
Part II: The Diagnosis of COVID ARF in Elderly
5: Differential Diagnosis of Types of Pneumonia in the Elderly
5.1 Introduction
5.2 Aging of the Respiratory System and the Impact of Pneumonia
5.3 Epidemiology
5.4 Causes 5.5 Routes of Transmission
5.5.1 Inhalation (Fig. 5.1)
5.5.2 Aspiration (Fig. 5.2)
5.5.3 Hematogenous Spread (Fig. 5.3)
5.5.4 Direct Extension from Adjacent Infected Foci (Fig. 5.4)
5.6 Clinical Presentation
5.7 COVID-19 Pneumonia "Phenotypes"
5.7.1 L-Phenotype
5.7.2 H-Phenotype
5.8 Risk Stratification
5.8.1 CURB-65 (Table 5.3)
5.8.2 Pneumonia Severity Index, Also Known as the PORT Score (Fig. 5.5 and Table 5.4)
5.8.3 IDSA/ATS CAP Criteria
5.8.4 COVID-GRAM Critical Illness Risk Score 5.8.5 Brescia-COVID Respiratory Severity Scale (BCRSS)/Algorithm
5.9 Imaging
5.10 Laboratory Investigations
5.11 Microbiologic Diagnosis
5.12 Viral Aetiology (Fig. 5.9)
5.13 Viral Pneumoniae Diagnosis: Upper Respiratory Sample Collection
5.13.1 Nasopharyngeal Swab/Oropharyngeal (Throat) Swab (Fig. 5.10)
5.13.2 Nasal Mid-Turbinate (NMT) Swab, Also Called Deep Nasal Swab
5.13.3 Nasopharyngeal Wash/Aspirate or Nasal Wash/Aspirate (Fig. 5.12)
5.13.4 Sputum
5.13.5 Storage
References
6: The Diagnosis of COVID ARF in Elderly: The Radiological Findings in Elderly 6.1 Introduction
6.2 Radiology of the Normal Aging Lung and COVID-19 Disease
6.3 Chest Imaging in Elderly COVID-19 Patients
6.4 Imaging of COVID-19 Pneumonia Complications
6.5 Conclusion
References
Part III: The Screening and the Access to ICU
7: The Screening and the Access to ICU
7.1 The Recommendations of the Intensive Caring Scientific Societies
7.1.1 The Usual Screening and the Access to ICU
7.1.2 The Guidelines During COVID-19 Epidemy
7.2 Conclusion
References