Статья
Новая коронавирусная инфекция SARS-CoV-2 у пациентов пожилого и старческого возраста: особенности профилактики, диагностики и лечения. Согласованная позиция экспертов Российской ассоциации геронтологов и гериатров
Новая коронавирусная инфекция, вызванная вирусом SARS-CoV-2 (COVID-19), представляет особую угрозу людям пожилого и старческого возраста. Профилактические мероприятия в отношении людей пожилого и старческого возраста должны охватывать три области: 1) профилактику собственно инфицирования вирусом, 2) сохранение функционального статуса и профилактику гериатрических синдромов, включая использование мер социальной поддержки, 3) контроль коморбидных состояний. Клиническая картина COVID-19 у пациентов старшего возраста может быть атипичной, при этом легкость симптомов (отсутствие лихорадки, кашля, одышки) может не соответствовать тяжести прогноза. Делирий может быть первой манифестацией COVID-19, что требует особой тщательности его скрининга. Ведение пациентов пожилого и старческого возраста с COVID-19 должно включать мероприятия по профилактике делирия, выявлению и коррекции нарушения питания (мальнутриции). Риск нарушения питания с развитием саркопении повышается при госпитализации пациента, особенно при помещении на искусственную вентиляцию легких, ассоциируется с неблагоприятным прогнозом в период госпитализации, в дальнейшем ускоряет прогрессирование старческой астении и снижает качество жизни. Гериатрическая оценка является краеугольным камнем определения тактики ведения пациента пожилого и старческого возраст.
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