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

Enrico Brunetti, MD


November 07, 2022

Patients with heart failure are particularly susceptible to serious COVID-19 outcomes and should therefore stay up to date with vaccination, which has shown to be highly effective at reducing mortality in real-world settings.

Post-vaccination, COVID-19 infection immunity typically wanes after a period of 6 months, making a booster vaccine critical. Staying up to date with vaccination is also particularly urgent in older adults, as COVID-19 mortality is independently associated with patient age. As seen in the present case, older individuals may be frail and often have underlying health conditions that put them at higher risk for poorer outcomes.

A study conducted prior to the Omicron variant becoming dominant from the Italian National Institute of Health concluded that older adults who received a booster vaccine were 75% less likely to be infected, with up to 83.7% lower risk for hospitalization and ICU admission, and an 81% lower risk for death. While vaccination remains effective at preventing severe disease, improved immune evasion by new variants significantly reduces protection against transmission. Furthermore, protection against severe outcomes gradually wanes over several months, even after a booster.


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