This book describes the issues and challenges that clinicians encountered in the management of older critically ill patients during the Covid-19 pandemic, and offers practical information on how to manage them. Older adults are more susceptible to complications such as acute respiratory distress syndrome (ARDS) as a result of viral pneumonia. In addition, they often have multiple comorbidities and are commonly frail, which means their various organs and systems, such as the respiratory system, have reduced functional reserves. As such, older adults are less able to react to acute stressors. During the current Covid-19 pandemic, older adult patients' mortality is increased. Further, the infection and death rates of elderly people in nursing homes and health care institutions are high.

Management of older adults with Covid is complicated. The reduced availability of beds may limit their access to ICU. Moreover, the prognosis may be poor, and airway management and ventilation strategies have to take into account various clinical and physiological characteristics specific to older patients.

This book is addressed to all allied professionals involved in the management of older critically ill patients and presents information collected and practical lessons learned from the clinical daily management of this population during the pandemic. 

Part 1. Epidemiology

Chapter 1. Mortality and prognosis of older patients during COVID-19 pandemic
Chapter 2.  Elderly pneumonia COVID 19  cases : impact on the outcome
Chapter 3. Incidence of ARF due to COVID 19 interstitial pneumonia
Chapter 4. Changing the demographics in ICU Touring the Covid 19 pandemic
Part 2. The diagnosis of  COVID ARF in Elderly
Chapter 5. Differential Diagnosis of Types  of Pneumonia in the Elderly
Chapter 6. The diagnosis of  COVID ARF in Elderly: the radiological findings in elderly
Part 3. The screening and the access to ICU
Chapter 7. The screening and the access to ICU
Chapter 8. The decision - making process of selection in the clinical pathway for COVID 19: the recommendations for older patients
Chapter 9. COVID-19: End of life care decision making and preferences in older people
Part 4. Management of ARF
Chapter 10. The impact frailty, comorbidity and ageing of the respiratory system on theunfavourable prognosis of COVID 19
Chapter 11. THE PHYSIOPATHOLOGY OF COVID ACUTE RESPIRATORY FAILURE
Chapter 12. Escalation therapy for ARF in elderly patient
Chapter 13. Oxygen Therapy :  liberal versus conservative in older patients with COVID disease
Chapter 14.  The role of non-invasive ventilation
Chapter 15. The invasive ventilation in older patients: the timing
Chapter 16. The role of ECMO
Chapter 17. The role of HFNC
Chapter 18. The Problem of Aerosolization
Part 5. The setting
Chapter 19. The older patients in Subacute Units
Chapter 20. The ICU
Chapter 21. The admission of older patients with COVID 19  in the general wards
Chapter 22. The management of elderly patients with Covid out of the Hospital: the Italian experience
Part 6. Conclusion
Chapter 23. The geriatric perspectives in the time of COVID 19.