COVID-19 Spiraling of Frailty in Older Italian Patients

Excerpt

The world aging population is continuously rising and Italy is the second country following Japan with the largest concentration of persons living over the age of 65 years (1). At the moment, 22.4% of the Italian population is over the age of 65 years. Even though reaching advanced age in any country should be considered a significant and outstanding accomplishment, such triumph does not seem to come without sacrifice. Advanced aging is also accompanied by the increase in the risk of numerous comorbidities, such as arterial hypertension, heart disease, dementia, osteoporosis, cancer, Type 2 Diabetes, as well as other disease states that require continuous medical treatment. Most of these treatments require individual geriatric care modeling in order to maintain a “healthy” equilibrium necessary to avoid the irreversible spiral of the Frailty Syndrome. Frailty has been defined as a “syndrome characterized by a clinical state in which there is an increase in an individual’s vulnerability for developing an increased dependency and/or mortality when exposed to a stressor” (2). Frailty should be considered a constantly evolving syndrome and only reversible if appropriate intervention is quickly recognized and applied. Indeed, there is substantial literature underlining the importance of geriatric medicine toward frailty prevention and clinical criteria to rapidly identify those with frailty or pre-frailty (3‐5). If any negative health conditions break the equilibrium, the irreversible downward spiraling of frailty will begin. Over the last few months, there has been a worldwide rise infection of Coronavirus disease (COVID-19). As of March 27th, the country of Italy has over 79,900 persons infected with COVID-19 and 7590 deaths associated with COVID-19. Therefore, due to the rapid spread of the coronavirus in Italy, there seems to be a deadly trend toward mortality with COVID-19 in older patients with specific comorbidities, thus identifying a new “COVID Spiraling Frailty Syndrome”. This brief commentary will provide recent findings related to age-related comorbidities commonly found in advanced age and their percentages in older Italians that have recently died with a COVID-19. We will also consider potential aspects of different drugs for such comorbidities and COVID-19. This commentary specifically focuses on the Italian population of older patients in the last month of disease spread. …