Rapidly managing pneumonia in older people during a pandemic

Abstract

The current COVID-19 pandemic has highlighted the risk faced by older adults, who are more susceptible to complications, including acute respiratory distress syndrome, usually as a result of pneumonia. Comorbidities, impaired immunity and frailty, including a reduced ability to cough and to clear secretions from the lungs, can all contribute to this complication. Older people are therefore more likely to develop severe pneumonia, suffer from respiratory failure, and die. Viruses are thought to cause about 50% of cases of pneumonia. Viral pneumonia is generally less severe than bacterial pneumonia but can act as a precursor to it. Preventing any pneumonia in older adults is preferable to treating it. Identification of the early stages of pneumonia in older patients can prove difficult. Traditional symptoms and signs, including fever, may be absent. Limited evidence suggests that many tests that are useful in younger patients do not help diagnose infections in older adults. The onset of pneumonia in elderly people can often be rapid, and the prognosis is poor in severe pneumonia: as many as one in five will die. The older you are, the more prevalent severe pneumonia becomes.