COVID-19 in Older People: A Rapid Clinical Review

Fiona E Lithander*, Sandra Neumann, Emma Tenison, Katherine Lloyd, Tomas J Welsh, Jonathan C L Rodrigues, Julian P T Higgins, Lily Scourfield, Hannah Christensen, Victoria J Haunton, Emily Henderson

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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The COVID-19 pandemic poses a high risk to older people. The aim of this paper is to provide a rapid overview of the COVID-19 literature, with a specific focus on older adults. We frame our findings within an overview of the disease and have also evaluated the inclusion of older people within forthcoming clinical trials.

We searched PubMed and bioRxiv/medRxiv to identify English language papers describing the testing, treatment and prognosis of COVID-19. PubMed and bioRxiv/medRxiv searches took place on 20th and 24th March 2020, respectively.

Screening of over 1,100 peer-reviewed and pre-print papers yielded n=22 on COVID-19 testing, n=15 on treatment and n=13 on prognosis. Viral-PCR and serology are the mainstays of testing but a positive diagnosis may be increasingly supported by radiological findings. The current evidence for the effectiveness of antiviral, corticosteroid and immunotherapies is inconclusive, although trial data are largely based on younger people. In addition to age, male gender and comorbidities, specific laboratory and radiology findings are important prognostic factors. Evidence suggests social distancing policies could have important negative consequences, particularly if in place for an extended period.

Given the established association between increasing age and poor prognosis in COVID-19, we anticipate that this rapid review of the current and emergent evidence might form a basis on which future work can be established. Exclusion of older people, particularly those with comorbidities, from clinical trials is well recognised and is potentially being perpetuated in the field of current COVID-19 research.
Original languageEnglish
Pages (from-to)501–515
Number of pages15
JournalAge and Ageing
Issue number4
Early online date6 May 2020
Publication statusPublished - 1 Jul 2020

Structured keywords

  • Covid19


  • COVID-19
  • pandemic
  • virology
  • prognosis
  • older adults
  • non-pharmaceutical interventions

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