Geriatric Health Care During the COVID-19 Pandemic: Managing the Health Crisis

Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study

AIMS

To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care.

DESIGN

A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service.

METHODS

Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper.

RESULTS

A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened.

CONCLUSIONS

COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition.

IMPACT

Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience

PURPOSE OF REVIEW

Telemedicine quickly became integrated into healthcare caused by the Coronavirus 19 (COVID-19) pandemic. Rapid use of telemedicine into healthcare systems was supported by the World Health Organization and other prominent national organizations to reduce transmission of the virus while continuing to provide access to care. In this review, we explored the effect of this swift change in care and its impact on older adults with cancer.

RECENT FINDINGS

Older adults are susceptible to the COVID-19 virus caused by various risk factors, such as comorbidity, frailty, decreased immunity, and cancer increases vulnerability to infection, hospitalization, and mortality. We found three major themes emerged in the literature published in the past 18 months, including access to care, telemedicine modes of communication, and the use of technology by older adults with cancer. These findings have brought insight into issues regarding healthcare disparities.

SUMMARY

The utilization of telemedicine by older adults with cancer has potential future benefits with the integration of technology preparation prior to the patient's initial visit and addressing known health disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow older adults with cancer the flexibility needed to obtain quality cancer care.

The published trend of studies on COVID-19 and diabetes: bibliometric analysis

Background

Since the COVID-19 pandemic outbreak, diabetes mellitus (DM) has been at the core of the confirmed risk factors for fatal or critical care unit-treated COVID-19 and COVID-19 related complications. Although relevant studies on DM have developed rapidly during the COVID-19 pandemic. However, the aforementioned research results have not been systematically quantified by means of bibliometric analysis.

Purpose

The purpose of this study is to provide a comprehensive analysis of the current status and trends of publications related to DM research during the COVID19 epidemic.

Methods

A bibliometric analysis was performed using the Web of Science database. In this study, we used citespace, R software and R-Bibliometrix to analyze keywords, most-cited authors, most-cited countries, most-cited global documents, and co-occurrence and co-citation networks.

Results

A total of 1688 publications was included in this study. Investigators from the United States contributed the most publications. The United States, China and Europe have the most collaboration with the other countries/regions. A total of 3355 institutions made contributions to this study. Of the top 10 institutions with the most publications, N8 Research Partnership showed the most centrality. Among the top 10 journals, Diabetes Research and Clinical Practice published the most articles. Among authors included, Khunti Kamlesh is rated first with 27 papers and has the highest centrality. The most frequently co-cited article is entitled "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study". The most popular keywords included diabetes, mortality, diabetes, outcome, occurrences, risk, and type 1 diabetes.

Conclusion

This bibliometric study provides an overall picture of DM research and research trends during the COVID-19 pandemic and provides a basis for researchers to develop their next research strategies.

The impact of COVID-19 pandemic on the geriatric inpatient unit

OBJECTIVE

We aimed to determine the effects of the pandemic on the inpatients in the geriatric unit by comparing the demographic and clinical characteristics, reasons for hospitalization, morbidity, and mortality of the patients before and during the pandemic.

METHODS

The population of this retrospective, cross-sectional study consisted of inpatients in the geriatric unit for two years (11 March 2019-10 March 2021). The patients were separated into two groups according to the hospitalization time as pre-COVID-19 and COVID-19 period. Hospitalization types, reasons for hospitalization, length of stay, demographic data, chronic diseases, drugs, developed morbidities, discharge, and 1-year mortality status of the patients were recorded.

RESULTS

Three hundred and fifty patients were included in our study. The mean age was 80.4 ± 8.02. It was observed that the number of hospitalized patients decreased by ∼50% in the COVID-19 period. However, there was a significant decrease in hospitalization due to the control of chronic diseases during the COVID-19 period (p = .008). The number of inpatients from the emergency department was found to be higher during the COVID-19 period (p < .001). Regarding the presence of geriatric syndromes, polypharmacy (p = .011) and delirium (p = .035) were found to be significantly less in the pre-COVID-19 period. The percentage of malnutrition was also detected as lower, but it was not statistically significant. In terms of 1-year mortality, although not statistically significant, the all-cause mortality rate was higher during the COVID-19 period (p = .08).

CONCLUSIONS

Pandemic has greatly affected the geriatric unit. The prognosis of the patients has worsened and mortality rates have increased. Physiological and psychological deterioration caused by quarantine measures, worsening chronic diseases, and immunosenescence affected the prognosis of geriatric patients. This adds to the previous literature by proving the fact that older individuals are the most vulnerable group in the pandemic.

Bounce Forward Better: Geriatric and Gerontological Research in the Post-pandemic Future

In recent years, we have faced challenges in managing coronavirus disease 2019 (COVID-19), especially in older adults. The pandemic has precipitated a global health crisis that impeded older adults from maintaining their health. Disruption of the routine management of chronic diseases, physical inactivity deteriorating physical function and quality of life, malnutrition, and mental disorders have been suggested as major threats to the health of older adults. To address these problems and facilitate reactivation of normal care activities, this article summarizes the contents of a webinar held by the Annals of Geriatric Medicine and Research (AGMR) regarding the future directions of geriatric medicine and research in the post-COVID-19 era.

The published trend of studies on COVID-19 and dietary supplements: Bibliometric analysis

BACKGROUND

There are no guidelines on dietary supplements for the prevention or treatment of COVID-19. Therefore, we would like to analyze and discuss the above confusion through the bibliometric analysis.

METHODS

On 3 September 2022, we conducted a search of all relevant literature retrieved from the WOS core collection database from 2019 to 2022. CiteSpace software is used to build the visual co-occurrence network.

RESULTS

In the study of "COVID-19 and Dietary Supplements", the total of 170 authors published 855 articles in 451 journals. Several distinct core author groups were formed by Wang, Grant, Singh, Zhu, and other authors with numerous publications. The majority of the publications came from the Shahid Beheshti University of Medical Sciences. The United States of America had the highest number of publications. By analyzing keyword clusters, we found that the research focus was dietary supplements (vitamin D, vitamin K, vitamin C), mechanisms (ferritin, specialized pro-resolving mediators (SPMs), oxidative stress), research methods (clinical trials), and the prevention and treatment strategies (lockdown) of COVID-19.

CONCLUSIONS

vitamin D is the mainstream dietary supplement for COVID-19. There are still numerous controversies that deserve further discussion. Such as whether the use of vitamin D or TCM offers benefits, and whether the addition of dietary supplements during the lockdown measures can help prevent COVID-19 infection.