Favorable outcome of geriatric telemedicine for frail older adults with COVID-19 staying at home during the omicron tsunami in Hong Kong

Abstract

<p>Hong Kong was hit by a tsunami of COVID-19 in mid-February 2022, impacting on frail older adults with high COVID-19 mortality. Two older adults with COVID-19 managed by geriatric telemedicine at home were reported with favorable outcome despite severe frailty (Clinical Frailty Score 7). Stressed by COVID-19, both presented with the geriatric giants or frailty syndromes of brain failure (delirium) and balance failure (falls). Their successful outcome resulted not from COVID-19 antiviral treatment, but individualized holistic person-centered care attending to the frailty syndromes: optimized treatment of comorbid conditions by medication review, medication reduction on recognition of drug-induced hypotension and hypoglycaemia, appropriate use of medication to reduce iatrogenesis, caregivers' replenishment of fluid and nutrition deficit, oxygen support during critical hypoxic period, and recognition and early treatment of superimposed infections (bacterial respiratory tract superinfection, herpes zoster). Their social support was good. Family members and helpers became invaluable resources in providing the much-needed personal care, nutrition, hydration, comfort, and health monitoring to keep the geriatrician informed of their condition and to draw up an individualized management plan. Home environment and human presence were therapeutic in delirium care, avoiding damage from separation and isolation commonly practiced in this COVID-19 pandemic.</p>