Delirium and Covid-19 in the old adults: practical implications / Confusion et Covid-19 chez la personne âgée : implications pour la pratique

Covid-19 is the pathology associated with infection with the pandemic SARS-Cov-2 coronavirus. In people over 75 years of age, several studies alert clinicians to specificities. In particular, the confusion, acute brain failure, appears to be linked to Covid-19. This review of the literature explores the implications for practice of the presence of delirium during Covid-19 at the level of: epidemiology, pathophysiology, diagnostic phase, prerequisites and management. It also details the implications of post-acute infection.

La Covid-19 est la pathologie liée à une infection au coronavirus pandémique SARS-Cov-2. Chez les personnes âgées de plus de 75 ans, plusieurs études alertent les cliniciens sur des spécificités. En particulier, la confusion, altération fonctionnelle cérébrale aiguë, semble être liée à la Covid-19. Cette revue de la littérature explore les implications pour la pratique de la présence d'un tableau confusionnel dans la Covid-19 au niveau : de l'épidémiologie, de la physiopathologie, de la phase de diagnostic, des préalables et de la prise en charge. Elle détaille aussi les implications dans les suites de l'infection aiguë.

[Delirium, a possible typical presentation of COVID-19 in the elderly]. / La confusion aiguë, une possible présentation typique de la Covid-19 chez la personne âgée.

COVID-19 has hit the entire world since late 2019 and is starting to be medically better known. Its clinical presentation is atypical in the elderly. Acute confusion is a sometimes unrecognized warning sign. It is also an  element of severity of COVID-19. This viral infection should be systematically investigated for any confusional syndrome in the elderly population.

COVID-19 disclosure and end-of-life support during lockdown in an acute geriatric unit

In late 2019, the SARS-Cov-2 coronavirus emerged from the animal world and crossed to humans. The COVID-19 epidemic broke out in China and was declared a pandemic by WHO in March 2020. In France, hospitals in three regions experienced a massive influx of people with severe forms. COVID-specific units appeared. Within the hospital, the SARS-Cov-2 diagnostic announcement and palliative support (when indicated) required a specific approach to be developed. In an acute COVID geriatric unit, how should the diagnosis of this disease be disclosed in the setting of such intense hospital activity? What are the challenges to be met in order to offer appropriate support for these elderly people suffering from this new disease? This question is even more pressing in the setting of generalised lockdown.