Prevention, Diagnosis and Coping Strategies in Older Patients Suffering from COVID-19 During Its First Wave: An Overview in 6 Different Global European Initiative Countries (Hungary, Lebanon , Russian Federation, Slovenia, Tunisia and Turkey)

Coronavirus disease-2019 (COVID-19) pandemic starts abruptly in March 2020 catching almost all countries unprepared. Older adults were one of the most adversely affected individuals. In 2020 EuGMS (European Geriatric Medicine Society) e-congress, a specific session was dedicated to identify and compare the approaches during the first wave of the pandemic among Global European Initiative countries, which include active members from Eastern Europe, South-Eastern Europe, the Balkans and Mediterranean countries. We aimed to outline the management actions across the six countries (i.e., Hungary, Lebanon, Russian Federation, Slovenia, Tunisia and Turkey) involved in the session. We formulated four main questions to outline interest of four areas related to COVID-19 in individual countries: (i) The diagnosis protocol of COVID-19 for older adults, (ii) The hospitalization protocol for older adults with COVID-19, (iii) The governmental and social coping strategies against the pandemic and geriatricians' roles, (iv) Protection for the nursing home residents. The main areas of interest were detailed with standardized sub-questions to have a comparable standardized data between the participant countries. Diagnostic protocols for COVID-19 in older adults showed some differences across European countries; as half of the countries applied the algorithm suggested by World Health Organization, the other half developed their own algorithms. Of note, all countries indicated that the diagnostic procedures, protocols regarding hospitalization and intensive care unit transfer of older adults generally did not differ from young age groups. Although older age was considered as a criteria for admission in half of the countries, geriatric syndromes like frailty and malnutrition were generally overlooked. The common coping strategy against pandemic was to ensure older people stay at home and limit their social contact; by few of countries applying lock-downs only for specific age groups including older adults. Although restrictions and precautions taken in nursing homes were generally similar and mostly worked in protecting residents from COVID-19, some countries have indicated their observation of restrictions causing significant psychosocial negative effects on older adults. Although management of COVID-19 in older individuals seemed to be similar between countries in the whole picture, it seems geriatric perspective still needs to be more active on the scene, to prevent this vulnerable group from once again being exposed to increased psychosocial problems, morbidities and mortalities in a future pandemic.