Ethical Considerations Regarding Covid-19 Management in the Hospitalized Elderly Patient - Case Study
"Ethics and Deontology" Journal,
Vol. 1 No. 01 (2021): Ethics and Deontology Journal
Abstract
The infection with SARS-Cov-2, called Covid-19, with pandemic evolution declared by the WHO in March 2020, causes various forms of the disease; the severity increasing with age and the presence of comorbidities. The elderly patient with Covid-19 frequently requires hospitalization for treatment and medical supervision. This paper presents a retrospective study conducted on the case of the Clinical Hospital for Infectious Diseases in Brașov between 01.03.2021-31.03.2021, focused on highlighting ethical issues related to the peculiarities of medical care of patients over 65 years. During the mentioned period, the proportion of elderly patients was 51.48%% of the total hospitalizations, most of them presenting medium-severe and severe forms of disease and having associated multiple comorbidities. In this context, the care provided to the elderly patient hospitalized with Covid-19 must be non-discriminatory and must include equitable application of specific treatment, interventions in case of medical emergency and access to specialized services for chronic diseases associated with their decompensation.
Keywords
- Bonanad C, García-Blas S, José Tarazona-Santabalbina F, et al., (2020), Coronavirus: the geriatric emergency of 2020. Joint document of the Section on Geriatric Cardiology of the Spanish Society of Cardiology and the Spanish Society of Geriatrics and Gerontology. Rev Esp Cardiol. 2020 Jul;73(7):569-576. doi: 10.1016/j.recesp.2020.03.027. Epub 2020 Apr 3
- Britannica, (2021), COVID-19 in 20 Questions, https://www.britannica.com/list/covid-19-in-20-questions, accesat la 10 iulie 2021.
- Cennimo D., Coronavirus Disease 2019 (COVID-19), https://emedicine.medscape.com/article/ 2500114-overview, accesat la 11 iulie 2021.
- ECDC, (2021), European Centre for Disease Prevention and Control. High-risk groups for COVID-19, https://www.ecdc.europa.eu/en/covid-19/high-risk-groups, accesat la 10 iulie 2021.
- EUGMS, (2021), European Geriatric Medicine. Statement of the EuGMS Executive Board on the COVID-19 epidemic, https://www.eugms.org/news/read/article/489.html, accesat la
- iulie 2021.
- Guan WJ, Ni ZY, Hu Y, et al., (2020), Clinical Characteristics of Coronavirus Disease 2019 in China, N Engl J Med, 2020 Apr 30; 382(18):1708-1720. doi: 10.1056/NEJMoa2002032.
- INS, (2021a), Centrul Național de Supraveghere și Control al Bolilor Transmisibile. Situație infecții coronavirus ( Covid 19) 12 07 2021, http://www.cnscbt.ro/index.php/situatia-la-nivel-global-actualizata-zilnic, accesat la 12 iulie 2021.
- INS, (2021b), Centrul Național de Supraveghere și Control al Bolilor Transmisibile. Analiză cazuri confirmate COVID 19, http://www.cnscbt.ro/index.php/analiza-cazuri-confirmate-covid19, accesat la 12 iulie 2021.
- Interim Clinical Guidance, (2021), Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19), https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html, accesat la 10 iulie 2021.
- Martínez-Sellés D, Martínez-Sellés H, Martinez-Sellés M., (2020), Ethical Issues in Decision-making Regarding the Elderly Affected by Coronavirus Disease 2019: An Expert Opinion. European Cardiology Review 2020;15:e48. DOI:https://doi.org/10.15420/ecr.2020.14.
- Onder G, Rezza G, Brusaferro S., (2020), Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020. doi:10.1001/jama.2020.4683.
- Q&A COVID-19, (2021), Questions and answers on COVID-19: Basic facts, https://www.ecdc.europa. eu/en/covid-19/questions-answers/questions-answers-basic-facts, accesat la 10 iulie 2021.
- WHO, (2020a), WHO Director-General's opening remarks at the media briefing on COVID-19 – 11.March.2020, https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020, accesat la 13 iulie 2021.
- WHO, (2020b), World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it; 2020, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it, accesat la 10 iulie 2021
- WHO, (2020c), World Health Organization. WHO director-general’s opening remarks at the media briefing on COVID-19-11 March 2020, https://www.who.int/director-general/speeches/ detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020, accesat la 10 iulie 2021.
References
Bonanad C, García-Blas S, José Tarazona-Santabalbina F, et al., (2020), Coronavirus: the geriatric emergency of 2020. Joint document of the Section on Geriatric Cardiology of the Spanish Society of Cardiology and the Spanish Society of Geriatrics and Gerontology. Rev Esp Cardiol. 2020 Jul;73(7):569-576. doi: 10.1016/j.recesp.2020.03.027. Epub 2020 Apr 3
Britannica, (2021), COVID-19 in 20 Questions, https://www.britannica.com/list/covid-19-in-20-questions, accesat la 10 iulie 2021.
Cennimo D., Coronavirus Disease 2019 (COVID-19), https://emedicine.medscape.com/article/ 2500114-overview, accesat la 11 iulie 2021.
ECDC, (2021), European Centre for Disease Prevention and Control. High-risk groups for COVID-19, https://www.ecdc.europa.eu/en/covid-19/high-risk-groups, accesat la 10 iulie 2021.
EUGMS, (2021), European Geriatric Medicine. Statement of the EuGMS Executive Board on the COVID-19 epidemic, https://www.eugms.org/news/read/article/489.html, accesat la
iulie 2021.
Guan WJ, Ni ZY, Hu Y, et al., (2020), Clinical Characteristics of Coronavirus Disease 2019 in China, N Engl J Med, 2020 Apr 30; 382(18):1708-1720. doi: 10.1056/NEJMoa2002032.
INS, (2021a), Centrul Național de Supraveghere și Control al Bolilor Transmisibile. Situație infecții coronavirus ( Covid 19) 12 07 2021, http://www.cnscbt.ro/index.php/situatia-la-nivel-global-actualizata-zilnic, accesat la 12 iulie 2021.
INS, (2021b), Centrul Național de Supraveghere și Control al Bolilor Transmisibile. Analiză cazuri confirmate COVID 19, http://www.cnscbt.ro/index.php/analiza-cazuri-confirmate-covid19, accesat la 12 iulie 2021.
Interim Clinical Guidance, (2021), Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19), https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html, accesat la 10 iulie 2021.
Martínez-Sellés D, Martínez-Sellés H, Martinez-Sellés M., (2020), Ethical Issues in Decision-making Regarding the Elderly Affected by Coronavirus Disease 2019: An Expert Opinion. European Cardiology Review 2020;15:e48. DOI:https://doi.org/10.15420/ecr.2020.14.
Onder G, Rezza G, Brusaferro S., (2020), Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020. doi:10.1001/jama.2020.4683.
Q&A COVID-19, (2021), Questions and answers on COVID-19: Basic facts, https://www.ecdc.europa. eu/en/covid-19/questions-answers/questions-answers-basic-facts, accesat la 10 iulie 2021.
WHO, (2020a), WHO Director-General's opening remarks at the media briefing on COVID-19 – 11.March.2020, https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020, accesat la 13 iulie 2021.
WHO, (2020b), World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it; 2020, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it, accesat la 10 iulie 2021
WHO, (2020c), World Health Organization. WHO director-general’s opening remarks at the media briefing on COVID-19-11 March 2020, https://www.who.int/director-general/speeches/ detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020, accesat la 10 iulie 2021.