Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective

To better characterize the management of older people presenting with COVID-19 in European hospitals during the first two waves. The majority of older patients admitted to the hospital were transferred to a specific geriatric COVID-19 unit. Respondents found it important to consult a palliative care specialist and spiritual counsellor. In some national guidelines in Europe, the clinical frailty scale was used in combination with other variables for decisions on treatment. This pandemic has illustrated collaboration between geriatricians and palliative care specialists to improve the care for older patients with severe disease and an uncertain prognosis. Screening for frailty can prove to be useful in decision-making in this scenario. Older patients were particularly vulnerable to severe COVID-19 disease resulting in high in-hospital mortality rates during the two first waves. The aims of this study were to better characterize the management of older people presenting with COVID-19 in European hospitals and to identify national guidelines on hospital admission and ICU admission for this population. Online survey based on a vignette of a frail older patient with Covid-19 distributed by e-mail to all members of the European Geriatric Medicine Society. The survey contained questions regarding the treatment of the vignette patient as well as general questions regarding available services. Additionally, questions on national policies and differences between the first and second wave of the pandemic were asked. Survey of 282 respondents from 28 different countries was analyzed. Responses on treatment of the patient in the vignette were similar from respondents across the 28 countries. 247 respondents (87