Frail geriatric patient with covid-19 infection: a case report

Abstract

Introduction: Covid 19 is a respiratory system disease caused by SARS-COV2. Geriatric patients with Covid-19 equipped with multiple comorbidities and a high vulnerability have high morbidity and mortality rates.Case illustrations: A 75-year-old woman presents with confusion and fever. She was treated in the previous hospital for 7 days, experienced a deterioration of consciousness and had respiratory failure, thus was referred to Kariadi Hospital.She had comorbid hypertension, type 2 diabetes mellitus and grade 2 osteoarthritis genu bilateral. Bodyweight 45kg, height 150cm, BMI 20kg/m2,blood pressure 100/58 mmHg,pulse 110x/minute, Respiratory rate 28x/minute, Temperature 38.5?, 93% oxygen saturation, Frailty Index 0.7, Katz Index G, Norton score 11/20. Leucocytes 9100,Lymphocytes 10%, Neutrophil Lymphocyte Ratio 2.2, Blood Glucose 247mg/dL, CRP 4.41mg/dL, Ferritin 5472.28,D-Dimer >20,000ug/dL, Fibrinogen498 mg/dL, Procalcitonin 0.39, Chest X-ray showed pneumonia infiltrates with cardiomegaly. The RT-PCR swab examination showed positive SARS-Cov-2. Brain CT showed lacunar infarct and aging atrophy cerebral. the patient was admitted to intensive isolation room because of acute respiratory distress syndrome and covid coagulopathy. After clinical improvement, the next problems that must be addressed in isolation rooms are frail, confusion, cerebral syndrome, immobility and grade 1 decubitus.Conclusion: Management of frail geriatric patients with Covid-19 has its challenges because of the high mortality rate. It requires a comprehensive and multidisciplinary approach.