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The Covid-19 pandemic is impacting the elderly people in drastic ways. It often presents with higher morbidity and adverse outcomes including mortality in the elderly. As a special age group, they face a significantly high risk for contracting the infection and developing severe illness due to physiological changes with aging and potential underlying health conditions.
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The clinical spectrum of COVID-19 varies from asymptomatic or pauci-symptomatic presentation to a moderate to severe state characterized by respiratory failure necessitating mechanical ventilation and ICU support. The elderly people are more likely to develop a severe and critical illness as compared to the younger age groups.
In general, the elderly men display a higher mortality than women, especially if there are one or more underlying chronic health conditions. The age-related decline in physiological functions, attributable to reduced organ reserve and gradual functional decline in various organs in the elderly, is the key factor. In addition, the aging associated alterations in the immune response, the immunosenescence accompanied by subclinical pro-inflammatory state and inflamm-aging, expose the elderly to higher infectivity and a severe form of illness. There is significantly reduced ACE2 expression with aging in the elderly age group in both genders, which is further reduced in the elderly with hypertension, heart disease and diabetes. The SARS-CoV-2 binding to ACE2 may exaggerates the...Competing Interests: None declared.References
- Matthew J. Weiss, Franco Carnevale, Bram Rochwerg, et al. Ensuring nondiscrimination in pandemic prioritization decisions. CMAJ 2020;192:E421-E421.
- Adverse Outcomes for Elderly in Covid-19: The Loss of the Longevity Dream, April 2020, Vinod Nikhra M.D., DOI: 10.13140/RG.2.2.34684.08328/1
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