Therapeutic Adaptation after COVID-19 Admission
In patients with advanced age who are admitted to hospital due to a severe SARS-CoV-2 infection, it is very important to establish a therapeutic adaptation plan from the time of admission. This plan should be clearly documented in the clinical history, making it clear whether or not the patient is a candidate for mechanical ventilation and, in case of their condition worsening, when to propose the withdrawal of life-sustaining therapies (Table 1). Decisions that maximise survival to hospital discharge, the number of years of life saved and the possibility of living each of the stages of life can be prioritised. In this regard, patients with minimal expected benefit should not be admitted to ICU and the admission of patients with a life expectancy <1–2 years should be carefully evaluated. This applies to patients of all ages. A utilitarian mentality should be applied, which should prevent prejudice against the elderly. For example, a frail elderly patient might have a low chance of surviving the prolonged intubation required to recover from COVID-19 pneumonia, but this is also the case for young patients with severe comorbidities.[11]