cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2020-2601cardiovascular-2601Research ArticleСОГЛАСОВАННОЕ МНЕНИЕ ЭКСПЕРТОВPOSITION AGREEMENT OF THE EXPERTSНовая коронавирусная инфекция SARS-CoV-2 у пациентов пожилого и старческого возраста: особенности профилактики, диагностики и лечения. Согласованная позиция экспертов Российской ассоциации геронтологов и гериатровNovel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatricshttps://orcid.org/0000-0002-4193-688XТкачеваО. Н.TkachevaO. N.

Ткачева Ольга Николаевна — доктор медицинских наук, профессор, директор ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России, главный внештатный гериатр Минздрава России

Москва 

tkacheva@rgnkc.ruhttps://orcid.org/0000-0002-1628-5093КотовскаяЮ. В.KotovskayaYu. V.

Котовская Юлия Викторовна — доктор медицинских наук, профессор, заместитель директора по научной работе ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава

Москва 

kotovskaya_yv@rgnkc.ruhttps://orcid.org/0000-0002-8075-2389АлексанянЛ. А.AleksanyanL. A.

Алексанян Лианна Александровна — доктор медицинских наук, профессор, заместитель директора по организационно-методической работе ОСП РНКЦ ФГАОУ ВО РНИМУ им.  Н. И. Пирогова Минздрава России

Москва 

aleksanyan_la@rgnkc.ruhttps://orcid.org/0000-0003-3367-467XМильтоА. С.MiltoA. S.

Мильто Анна Сергеевна — доктор медицинских наук, главный врач ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

milto_as@rgnkc.ruhttps://orcid.org/0000-0002-6253-621XНаумовА. В.NaumovA. V.

Наумов Антон Вячеславович — доктор медицинских наук, заведующий лабораторией заболеваний костно-мышечной системы ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России, профессор кафедры болезней старения ФДПО ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

naumov_av@rgnkc.ruhttps://orcid.org/0000-0002-3657-0676СтражескоИ. Д.StrazheskoI. D.

Стражеско Ирина Дмитриевна — кандидат медицинских наук, заместитель директора по трансляционной медицине, заведующий лабораторией трансляционных исследований в геронтологии ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

strazhesko_id@rgnkc.ruhttps://orcid.org/0000-0002-6021-7864ВоробьеваН. М.VorobyevaN. M.

Воробьева Наталья Михайловна — доктор медицинских наук, заведующий лабораторией сердечно-сосудистого старения ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

vorobyeva_nm@rgnkc.ruhttps://orcid.org/0000-0001-7891-6850ДудинскаяЕ. Н.DudinskayaE. N.

Дудинская Екатерина Наильевна — кандидат медицинских наук, заведующий лабораторией возрастных метаболических эндокринных нарушений ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

katharina.gin@gmail.comhttps://orcid.org/0000-0001-5964-5725МалаяИ. П.MalayaI. P.

Малая Ирина Павловна — кандидат медицинских наук, старший научный сотрудник лаборатории трансляционных исследований в геронтологии ОСП РГНКЦ ФГАОУ ВО РНИМУ им.  Н. И. Пирогова Минздрава России

Москва 

malaya_ip@rgnkc.ruhttps://orcid.org/0000-0002-1807-7546КрыловК. Ю.KrylovK. Yu.

Крылов Кирилл Юрьевич — врач-анестезиолог-реаниматолог ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

krkerk@gmail.comhttps://orcid.org/0000-0003-4934-5846ТюхменевЕ. А.TyukhmenevE. A.

Тюхменев Евгений Александрович — кандидат медицинских наук, заведующий консультативно-диагностическим отделением ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

tyukhmenev_ea@rgnkc.ruhttps://orcid.org/0000-0002-5313-2715РозановА. В.RozanovA. V.

Розанов Александр Владимирович — кандидат медицинских наук, старший научный сотрудник лаборатории сердечно-сосудистого старения ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

rozanov_av@rgnkc.ruhttps://orcid.org/0000-0003-1222-3351ОстапенкоВ. С.OstapenkoV. S.

Остапенко Валентина Сергеевна — кандидат медицинских наук, заведующий отделением гериатрической терапии ОСП РГНКЦ ФГАОУ ВО РНИМУ им.  Н. И. Пирогова Минздрава России, ассистент кафедры болезней старения ФДПО ФГАОУ ВО РНИМУ им.  Н. И. Пирогова

Москва 

ostapenko_vs@rgnkc.ruhttps://orcid.org/0000-0002-2196-1068МаневичТ. М.ManevichT. M.

Маневич Татьяна Михайловна — заведующий отделением гериатрической неврологии ОСП РГНКЦ ФГАОУ ВО РНИМУ им.  Н. И. Пирогова Минздрава России

Москва 

manevich_tm@rgnkc.ruhttps://orcid.org/0000-0002-3981-4031ЩедринаА. Ю.ShchedrinaA. Yu.

Щедрина Анна Юрьевна — заведующий отделением гериатрической кардиологии ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

shedrina_au@rgnkc.ruhttps://orcid.org/0000-0002-3406-5123СеменовФ. А.SemenovF. A.

Семенов Федор Анатольевич — заведующий отделением анестезиологии-реаниматологии ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

semenov_fa@rgnkc.ruhttps://orcid.org/0000-0003-2597-981XМхитарянЭ. А.MkhitaryanE. A.

Мхитарян Элен Араиковна — кандидат медицинских наук, старший научный сотрудник лаборатории общей гериатрии и нейрогериатрии ОСП РГНКЦ ФГАОУ ВО РНИМУ им.  Н. И. Пирогова Минздрава России, доцент кафедры болезней старения ФДПО ФГАОУ РНИМУ им.  Н. И. Пирогова Минздрава России

Москва 

mkhitaryan_ha@rgnkc.ruhttps://orcid.org/0000-0002-3066-4866ХовасоваН. О.KhovasovaN. O.

Ховасова Наталья Олеговна — кандидат медицинских наук, доцент кафедры болезней старения ФДПО ФГАОУ РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

khovasova_no@rgnkc.ruhttps://orcid.org/0000-0003-0048-268XЕруслановаК. А.YeruslanovaK. A.

Ерусланова Ксения Алексеевна — младший научный сотрудник лаборатории сердечно-сосудистого старения ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва

eruslanova_ka@rgnkc.ruhttps://orcid.org/0000-0001-6792-8418КотовскаяН. В.KotovskayaN. V.

Котовская Наталья Вадимовна — врач-психиатр ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России, аспирантка кафедры психиатрии РУДН

Москва 

nataliakotovskaya@gmail.comhttps://orcid.org/0000-0002-6465-4842ШарашкинаН. В.SharashkinaN. V.

Шарашкина Наталья Викторовна — старший научный сотрудник лаборатории общей гериатрии и нейрогериатрии ОСП РГНКЦ ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России

Москва 

sharashkina@inbox.ruРоссийская ассоциация геронтологов и гериатровRussian Federation20200306202019326012601Copyright © Ткачева О.Н., Котовская Ю.В., Алексанян Л.А., Мильто А.С., Наумов А.В., Стражеско И.Д., Воробьева Н.М., Дудинская Е.Н., Малая И.П., Крылов К.Ю., Тюхменев Е.А., Розанов А.В., Остапенко В.С., Маневич Т.М., Щедрина А.Ю., Семенов Ф.А., Мхитарян Э.А., Ховасова Н.О., Ерусланова К.А., Котовская Н.В., Шарашкина Н.В., 20202020Ткачева О.Н., Котовская Ю.В., Алексанян Л.А., Мильто А.С., Наумов А.В., Стражеско И.Д., Воробьева Н.М., Дудинская Е.Н., Малая И.П., Крылов К.Ю., Тюхменев Е.А., Розанов А.В., Остапенко В.С., Маневич Т.М., Щедрина А.Ю., Семенов Ф.А., Мхитарян Э.А., Ховасова Н.О., Ерусланова К.А., Котовская Н.В., Шарашкина Н.В.Tkacheva O.N., Kotovskaya Y.V., Aleksanyan L.A., Milto A.S., Naumov A.V., Strazhesko I.D., Vorobyeva N.M., Dudinskaya E.N., Malaya I.P., Krylov K.Y., Tyukhmenev E.A., Rozanov A.V., Ostapenko V.S., Manevich T.M., Shchedrina A.Y., Semenov F.A., Mkhitaryan E.A., Khovasova N.O., Yeruslanova K.A., Kotovskaya N.V., Sharashkina N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2601

Новая коронавирусная инфекция, вызванная вирусом SARS-CoV-2 (COVID-19), представляет особую угрозу людям пожилого и старческого возраста. Профилактические мероприятия в отношении людей пожилого и старческого возраста должны охватывать три области: 1) профилактику собственно инфицирования вирусом, 2) сохранение функционального статуса и профилактику гериатрических синдромов, включая использование мер социальной поддержки, 3) контроль коморбидных состояний. Клиническая картина COVID-19 у пациентов старшего возраста может быть атипичной, при этом легкость симптомов (отсутствие лихорадки, кашля, одышки) может не соответствовать тяжести прогноза. Делирий может быть первой манифестацией COVID-19, что требует особой тщательности его скрининга. Ведение пациентов пожилого и старческого возраста с COVID-19 должно включать мероприятия по профилактике делирия, выявлению и коррекции нарушения питания (мальнутриции). Риск нарушения питания с развитием саркопении повышается при госпитализации пациента, особенно при помещении на искусственную вентиляцию легких, ассоциируется с неблагоприятным прогнозом в период госпитализации, в дальнейшем ускоряет прогрессирование старческой астении и снижает качество жизни. Гериатрическая оценка является краеугольным камнем определения тактики ведения пациента пожилого и старческого возраст.

A novel coronavirus infection SARS-CoV-2 (COVID19) is especially dangerous for elderly and senile patients. Preventive measures for elderly people should cover three areas: 1) direct prevention of the viral infection, 2) preservation of the functional status and prevention of geriatric syndromes, including the use of social support measures, 3) control of comorbidities. The clinical pattern of COVID-19 in older patients may be atypical, while the mildness of symptoms (no fever, cough, shortness of breath) may not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, which requires special care in its screening. Management of elderly and senile patients with COVID19 should include measures for delirium prevention, the detection and improvement of nutrition. The risk of malnutrition with sarcopenia increases with hospitalization of a patient, especially when using artificial ventilation, is associated with an unfavorable prognosis during hospitalization, accelerates the progression of senile asthenia and reduces the quality of life. Geriatric assessment is the cornerstone of determining the management of an elderly patient.

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The authors declare that there are no conflicts of interest present.