Specifics of COVID-19 therapy in elderly, senile, and long-living patients: pharmacoepidemiological study data

Abstract

BACKGROUND: The effect of age on COVID-19 course and specifics of drug therapy in geriatric patients represent relevant issues for research.

AIM: To study the age-dependent structure of drug prescriptions in COVID-19 patients admitted to the infectious diseases department of the Volgograd region in 2020–2022; to assess the effectiveness and safety of drug therapy in elderly, senile, and long-living patients.

MATERIALS AND METHODS: The analysis was based on the medical records of all patients diagnosed with COVID-19 and treated at the infectious diseases hospital of the Volgograd region in September 2020, March and September 2021, March, September and November 2022.

RESULTS: The odds of lethal outcome in COVID-19 patients ≥60 years of age within 60 days from admission were 6 times higher than in patients <60 years of age (odds ratio 6.21; 95% confidence interval 3.68–10.49). In 2022, the odds of lethal outcome in patients ≥60 years of age receiving antiviral drugs (remdesivir or favipiravir) were 64% lower compared to patients ≥60 years of age who did not receive any causal treatment (odds ratio 0.36; 95% confidence interval 0.20–0.69, p < 0.05). The odds of hemorrhagic complications were higher among patients ≥75 years of age receiving anticoagulants compared to patients <60 years of age (odds ratio 5.99; 95% confidence interval 1.27–28.36).

CONCLUSIONS: Given the atypical forms of COVID-19 in the elderly, it is worth paying more attention to timely diagnosis and the prescription of etiotropic therapy, prevention of severe complications and conditions associated with death, and also more cautiously assessing the risks of prescribing anticoagulants due to the high incidence of side effects.

Keywords

COVID-19 / antiviral therapy / remdesivir / favipiravir / genetically engineered biological drugs / anticoagulants / elderly patients / senile patients / long-living patients / Beers criteria

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