Ways of Protecting Religious Older Adults from the Consequences of COVID-19.
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ABSTRACT:
SUBMITTER: Koenig HG
PROVIDER: S-EPMC7152884 | biostudies-literature | 2020 Jul
REPOSITORIES: biostudies-literature
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Ways of Protecting Religious Older Adults from the Consequences of COVID-19.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 20200412 7
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Project description:Purpose: This study aims to characterize the early innate and adaptive responses induced by SARS-CoV-2 infection in children and adults over time up to 8 weeks post symptoms onset (POS). We report the gene signature of COVID-19 over the course of the disease in both age groups. The kinetic of infection was divided in 5-time intervals according to the calculated days POS: interval 1 (0-5), interval 2 (6-14), interval 3 (15-22), interval 4 (23-35), and interval 5 (36-81). Methods: RNA extraction was performed automatically via the PAXgene Blood miRNA Kit and the QIAcube instrument (Qiagen) following the manufacturer’s protocol. RNA concentration and quality were assessed by using the Qubit instrument (Invitrogen) and the Agilent 2100 Bioanalyzer, respectively. The Stranded Total RNA Ribo-Zero Plus kit from Illumina was used for the library preparation with 100 ng of total RNA as input. Library molarity and quality were assessed with the Qubit and Tapestation using a DNA High sensitivity chip (Agilent Technologies). Libraries were pooled at 2 nM for clustering and sequenced on an Illumina HiSeq 4000 sequencer for a minimum of 30 million single-end 100 reads per sample. Main results: (I) we observed an antiviral-IFN-signature and innate-cell-activation within the first 5 days post symptoms onset (POS), while genes associated with CD4 T-cell responses, plasma cells and immunoglobulin were upregulated in both age groups during the first two weeks POS, indicative of SARS-CoV-2-specific adaptive immune responses; (II) in adults, genes associated with IFN antiviral responses and activated dendritic cells were maintained during the second week of disease, and subsided only after 14 days. By contrast, those transcriptome changes subsided already after 5 days in children.
2021-09-22 | GSE166190 | GEO
Project description:PurposeIn the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases.MethodsWe review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors.ResultsSeveral cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins.ConclusionsMost current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.
| S-EPMC8143992 | biostudies-literature
Project description:In children and younger adults up to 39 years of age, SARS-CoV-2 usually elicits mild symptoms that resemble the common cold. Disease severity increases with age starting at 30 and reaches astounding mortality rates that are ~330 fold higher in persons above 85 years of age compared to those 18-39 years old. To understand age-specific immune pathobiology of COVID-19 we have analyzed soluble mediators, cellular phenotypes, and transcriptome from over 80 COVID-19 patients of varying ages and disease severity, carefully controlling for age as a variable. We found that reticulocyte numbers and peripheral blood transcriptional signatures robustly correlated with disease severity. By contrast, decreased numbers and proportion of naïve T cells, reported previously as a COVID-19 severity risk factor, were found to be general features of aging and not of COVID-19 severity, as they readily occurred in older participants experiencing only mild or no disease at all. Single-cell transcriptional signatures across age and severity groups showed that severe but not moderate/mild COVID-19 causes cell stress response in different T cell populations, and some of that stress was unique to old severe participants, suggesting that in severe disease of older adults, these defenders of the organism may be disabled from performing immune protection. These findings shed new light on interactions between age and disease severity in COVID-19.
2023-01-11 | GSE212584 | GEO
Project description:Background and objectivesPeople aged 65 and over, deemed most "vulnerable" by public health, were targeted by the COVID-19 protection measures which sought to minimize physical contact and social activities. Older adults living alone were particularly impacted by these measures. However, such measures meant to protect the older population may not have necessarily reflected older adults' individual prioritization choices. This study therefore aimed to understand how protecting oneself over the virus was considered in the prioritization of other health and social needs of older adults living alone during the pandemic.Research design and methodsThis study adopted a qualitative design. A total of 17 semi-structured interviews was conducted between May 2021 and June 2022 with older adults living alone. All interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis as defined by Braun and Clarke (2018, 2019) was performed.ResultsOur analysis showed two forms of prioritization across two themes. This first theme focused on participants who reported prioritizing protecting themselves over the virus by limiting in-person contact and activities. The second theme showed that although several participants reported that protecting themselves over the virus was important to them, the prioritization of this need was not shared by all and, in some cases, evolved over the course of the pandemic.Discussion and implicationsOur study demonstrated heterogeneity in the prioritization of older adults needs. Future public health recommendations should consider these variations in the needs and priorities of older adults when determining public health measures.
| S-EPMC11342055 | biostudies-literature
Project description:BackgroundClinical presentation and risk factors of death in COVID-19 in oldest adults have not been well characterized.ObjectivesTo describe clinical features and outcome of COVID-19 in patients older than 85 years and study risk factors for mortality.DesignProspective cohort.Participants and settingPatients aged 85 years and older, admitted in noncritical care units at the University Hospital Lariboisière Fernand-Widal (Paris, France) for confirmed severe acute respiratory syndrome coronavirus 2 infection were included and followed up for 21 days.MeasurementsClinical and laboratory findings were collected. Cox survival analysis was performed to explore factors associated with death.ResultsFrom March 14 to April 11, 2020, 76 patients (median age = 90 (86-92) years; women = 55.3%) were admitted for confirmed COVID-19. Of the patients, 64.5% presented with three or more comorbidities. Most common symptoms were asthenia (76.3%), fever (75.0%) and confusion and delirium (71.1%). An initial fall was reported in 25.0% of cases, and digestive symptoms were reported in 22.4% of cases. COVID-19 was severe in 51.3% of cases, moderate in 32.9%, and mild in 15.8%. Complications included acute respiratory syndrome (28.9%), cardiac decompensation (14.5%), and hypotensive shock (9.0%). Fatality at 21 days was 28.9%, after a median course of disease of 13 (8-17) days. Males were overrepresented in nonsurvivors (68.2%). In survivors, median length of stay was 12 (9-19.5) days. Independent predictive factors of death were C-reactive protein level at admission and lymphocyte count at nadir.ConclusionSpecific clinical features, multiorgan injury, and high case fatality rate are observed in older adults with COVID-19. However, rapid diagnosis, appropriate care, and monitoring seem to improve prognosis.
| S-EPMC7675559 | biostudies-literature
Project description:BACKGROUND:It is increasingly recognised that older patients may not present with typical symptoms of COVID-19. AIMS:This study aims to evaluate the incidence, characteristics and clinical outcome of older adults with atypical presentations of COVID-19. METHODS:A retrospective analysis of adults ? 65 years with confirmed COVID-19 admitted to our institution between 1 March and 24 April 2020 was performed. Patients were categorised into typical or atypical groups based on primary presenting complaint in the community. RESULTS:One hundred twenty-two patients (mean age 81 ± 8 years; 62 male) were included. Seventy-three (60%) were categorised into the typical group and 49 (40%) into the atypical group. In the atypical group, common presenting complaints were fall in 18 (36%), reduced mobility or generalised weakness in 18 (36%) and delirium in 11 (22%). Further assessment by paramedics and on admission found 32 (65%) to have typical features of COVID-19, fever being the most common, and 22 (44%) were hypoxic. This subset had worse outcomes than those in the typical group with a mortality rate of 50% versus 38%, respectively, although this was not statistically significant (P = 0.27). No significant difference in mortality or length of hospital stay between the groups was demonstrated. CONCLUSION:Older patients with atypical presentation of COVID-19 in the community are equally susceptible to poor outcomes. Early detection may improve outcomes and limit community transmission. Primary care practitioners should be vigilant and consider prompt onward referral.
| S-EPMC7505490 | biostudies-literature
Project description:ObjectivesGlobally, mitigation measures during the coronavirus disease 2019 (COVID-19) pandemic have focused on protecting older adults. Earlier disaster studies have shown the importance of including older peoples' voices to prevent secondary stressors, yet these voices have received little attention during this pandemic. Here, we explore how Dutch older adults view this crisis and cope with measures to contribute to our understanding of coping of older adults in general and during disaster situations more specifically.MethodQualitative study using semistructured telephone interviews with 59 diverse older adults aged 54-95 throughout the Netherlands.ResultsOlder adults typify this crisis as ungraspable, disrupting their daily and social lives. Despite filling their lives with activities, they experience loss or lack of purpose. They try to follow measures to decrease infection risk and gain control, and use problem- and emotion-focused coping strategies. Emotion-focused strategies used were interpreting their personal vulnerability, self-enhancing comparisons, acceptance, and distraction. In the latter 2 strategies, the temporary nature of measures was emphasized.DiscussionOlder adults describe this crisis consistently with earlier findings from disaster studies. They use known coping strategies, but emphasize the duration in relation to their expectation of temporality. This underscores a dynamic, processual approach toward coping that incorporates temporal dimensions such as duration and order. Our findings stress the importance of acknowledging heterogeneity among older adults and adjusting communication about mitigation measures to decrease insecurity and increase resonance. This may make COVID-19 mitigation measures more manageable and age-responsible and allow older adults to start living again.
| S-EPMC7928596 | biostudies-literature
Project description:BackgroundThe SARS-CoV-2 pandemic led to a general uncertainty about risk and consequences of the disease. Older adults are specifically vulnerable with regard to severe courses of the disease and have been particularly encouraged to self-isolate during the pandemic. Subsequently, expressions of concern have been raised regarding the negative impact of disease risk and quarantine on the mental health of older people.ObjectivesAssessment of psychosocial stress, coping strategies, need for support, and sense of coherence of older people during the COVID-19 pandemic.Materials and methodsThe study follows a qualitative research design. Between May and June 2020 N = 11 guided telephone interviews were conducted with older adults (70+ years). Telephone interviews were recorded by audio tape and fully transcribed. A qualitative content analysis was performed according to Mayring and Fenzl (2019) using MAXQDA.ResultsParticipants were 74.8 years old on average. Participants showed predominantly good psychosocial health and functional coping strategies. Life experience, an optimistic attitude, understanding of the necessity of restrictions, and previous crises that have been mastered were the most important resources during the COVID-19 pandemic for older adults. Offers of support were rarely used. Participants were critical of the closing of centers or meeting points for older people.ConclusionOlder adults appear to be able to preserve their mental wellbeing during the COVID-19 pandemic. The relevance of mental resources of older adults for supporting younger generations seems to be unrecognized.
| S-EPMC7852481 | biostudies-literature
Project description:Background and objectivesHopelessness-a state of despair characterized by a negative outlook towards the future and a belief in insurmountable challenges-is a risk factor for major depression, cardiovascular disease, and all-cause mortality among older adults. It is also an understudied consequence of discrimination. Older blacks disproportionately report experiencing discrimination and, as a result, may be at greater risk of feeling hopeless. However, social and religious resources may protect against the adverse effects of discrimination. The current study examines whether social support, social engagement, religious attendance, and religiosity buffer the effects of self-reported everyday discrimination on hopelessness among a nationally representative sample of blacks.Research design and methodsUsing data from the 2010/2012 psychosocial assessment of the Health and Retirement Study, we regressed hopelessness on everyday discrimination, stratifying by 2 age groups, ages 51-64, representing middle-age (n = 1,302), and age 65 and older, representing old age (n = 887). Interaction terms tested whether each resource moderated the discrimination-hopelessness relationship controlling for depressive symptoms, socioeconomic status, and demographic characteristics.ResultsGreater reports of everyday discrimination were associated with higher levels of hopelessness for middle-aged and older blacks. For middle-aged blacks, the resources did not moderate the discrimination-hopelessness relationship; rather, higher levels of support (b = -0.294, p < .01), religiosity (b = -0.297, p < .001), religious attendance (b = -0.218, p < .05) were independently and inversely associated with hopelessness. For older blacks, higher levels of religiosity moderated the discrimination-hopelessness relationship (b = -0.208, p < .05) and higher levels of support (b = -0.304, p < .05) and social engagement (b = -0.236, p < .05) were independently and inversely associated with hopelessness.Discussion and implicationsFindings suggest that self-reported everyday discrimination increases hopelessness among middle-aged and older blacks but social and religious resources may counterbalance its effects, in age-specific ways, to protect against hopelessness. Religiosity may be especially important for older blacks as a buffer against the negative consequences of discrimination on hopelessness.
| S-EPMC7679998 | biostudies-literature
Project description:ObjectivesIn response to the coronavirus disease 2019 (COVID-19) pandemic, older adults are advised to follow social distancing measures to prevent infection. However, such measures may increase the risk of loneliness. The current study aimed to investigate (a) whether social distancing measures, particularly limiting close social interactions, are associated with loneliness among older adults, and (b) whether the association between social distancing measures and loneliness is moderated by sociodemographic characteristics.MethodData were from the fourth wave (April 29 to May 26, 2020) of the nationally representative Understanding America Study COVID-19 Survey. We used data on adults 50 years or older (N = 3,253). Logistic regression models of loneliness were performed. Five indicators of social distancing measures were considered: (a) avoiding public spaces, gatherings, or crowds; (b) canceling or postponing social activities; (c) social visits; (d) no close contact (within 6 feet) with people living together; and (e) with people not living together.ResultsCancelling or postponing social activities and avoiding close contact with people living together were associated with 33% (odds ratio [OR] = 1.33, confidence interval [CI] = 1.06-1.68, p < .05) and 47% (OR = 1.47, CI = 1.09-1.99, p < .05) greater odds of loneliness, respectively. Furthermore, limiting close contact with coresidents increased the probability of loneliness more for males, non-Hispanic Whites, and those with higher levels of education and income.DiscussionEfforts should be made to help older adults maintain social connectedness with close others by virtual communication methods. Our findings also call special attention to vulnerable groups at elevated risks of loneliness, emphasizing the need for tailored interventions.
| S-EPMC7928665 | biostudies-literature