Skill Checkup: An 81-Year-Old Woman With Dyspnea, Nearly Incessant Cough, and Body Aches

Enrico Brunetti, MD


November 07, 2022

Considering the patient's medical history and per the NICE COVID-19 guidelines, the Clinical Frailty Scale (CFS) should be used to acquire a complete picture of this patient's baseline health and guide treatment decisions. Patients with heart failure are at increased risk in the setting of COVID-19 owing to their frailty, compromised immunity, and reduced hemodynamic ability to fight off severe infections. For patients who are frail, lower medication doses may be needed.

The NICE panel also notes that patients who are older or frail with COVID-19 are at risk of being overtreated, advising that such risks should be discussed with these patients and their families.

As outlined by the European Society of Cardiology guidelines for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic, endomyocardial biopsy is not necessary for the routine assessment of patients with suspected COVID-19.

Using the CFS, the patient is determined to be moderately frail.


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