ABSTRACT
In the Coronavirus disease 2019 (COVID-19) pandemic, underlying diseases such as cardiovascular disease, respiratory illness, liver and kidney disease or malignancies, have a critical prognostic role for these patients. Due to the increased risk of mortality in patients with established or new-onset comorbidities, we decided to conduct a study to further investigate the possible comorbidities and treatment recommendations of COVID-19. All articles published by March 25, 2020, on the new coronavirus infection were reviewed and for cutaneous manifestation as a new emerging concern, by April 25, 2020. ScienceDirect, Google Scholar, Scopus, PubMed databases were searched, and keywords such as "COVID-19", "2019-nCoV", "Coronavirus2019", "SARS-CoV-2”, and "comorbidity" have been used. The most important comorbidity in elderly patients with confirmedCOVID-19 was cardiovascular disease, followed by diabetes and chronic respiratory disease, respectively, and on the other hand, COVID-19 itself could cause acute heart, lung, liver, kidney, and skin disease. Also, the prevalence of underlying diseases in dead patients or patients with severe COVID-19 is higher than the others. Considering treatment, drug interactions, and careful drug adjustment based on hepatic and renal metabolism are essential. The results of this study showed that the mortality rate and ICU admission in people with the underlying disease is higher than in other people. Also, we must pay attention to the possible multi-organ damages and comorbidities for the protection and successful treatment of COVID-19. There are some comorbidities like primary cutaneous manifestations that may have diagnostic or prognostic values in the COVID-19 course.
ABSTRACT
Background: During the COVID-19 pandemic, elderly individuals (with the chronological age of 65 years and above) are more susceptible to the SARS-CoV-2 infection complications due to altered immune system response and the higher rate of underlying comorbidities. A vast majority of mortalities are reported in elderly patients; thus, this study aimed to evaluate complications of COVID-19 in elderly patients. Methods: A systematic review was conducted according to MOOSE guidelines. Science Direct, Google Scholar, Scopus, PubMed databases were searched for published articles related to COVID-19 in the elderly up to March 26, 2020. Search MeSh terms included "Severe acute respiratory syndrome coronavirus 2", "2019-nCoV", "SARS-CoV-2", "comorbidity", "elderly", and "geriatrics". Results: In total 1360 potentially relevant articles were screened, of which 35 were relevant and their full texts were considered for the review. Organ damages to the pulmonary system, cardiovascular, liver, and renal system are more prevalent in the elderly with SARS-CoV-2 infection. As the chance of multiorgan involvement is more common among elderly patients, preventive, multidisciplinary, and holistic evaluations are essential to reduce disease consequences. Conclusion: More attention needs to be paid to elderly individuals in the quarantine. Social contact should be made and maintained through online facilities, media, and phone calls to ensure patients' mental health during this stressful situation. Also, they should be provided with enough food and medications by their families or friends. Also, providing social and volunteer services might play an important role in the mental health of those patients who have no social network.