The document discusses COVID-19 among elderly patients in Brazil. It first describes how SARS-CoV-2 infects host cells through the spike protein and hijacks the cell's machinery to replicate itself. It then notes that the first COVID-19 cases occurred in Wuhan in December 2019 and have since spread globally. Most patients treated in hospitals for COVID-19 were over 70 years old, and among deceased patients about 50% were over 83. The virus' symptoms in elderly patients did not always present as the typical fever, cough and dyspnea and were sometimes confused with other age-related illnesses. However, persistent diarrhea was found to be linked to COVID-19 infection in some cases.

1. COVID-19
AMONG ELDERLY
PATIENTS PACIENTES
IDOSOS - Brazil
The world in danger

2. As can be seen from the lesson by Rothan and Byrareddy
(2020), Coronavirus 19 is an enveloped RNA virus with a positive
single strand that primarily attacks the respiratory system and has the
“spike” protein, which favors its anchorage in the plasma membrane of
the respiratory tract. host cell, allowing the facilitation of endocytosis
by lipid oxidation of this membrane, giving this virus a formidable
invasive power, using, after invasion, the cellular machinery to
translate and transcribe its own genetic material, giving rise to new
viral specimens that , after maturation, they rupture the cell and infect
sites with a predilection for the respiratory system, in addition to
triggering a severe immune response in some individuals.
The first cases date from December 2019, occurred in the city
of Wuhan, when hospitalized patients presented with fever, dyspnea
and computed tomography with bilateral image of bronchial mesh
expansion in the multifocal “ground-glass” pattern. viral spread to
other regions of China and Asia, with cases even being reported in the
United States of America on January 30, 2020, during the care of a
patient coming from the hot zones of the initial epicenter of COVID-19
(ROTHAN and BYRAREDDY, 2020).
After the exponential growth of contamination by the
Coronavirus, it was noticed that most of the patients treated in the
nosocomial environment were over 70 years of age and, among those
who died, about 50% were over 83 years old. The viral pneumonic
manifestation in this population was not expressed by a spectrum of
typical signs such as fever, cough and dyspnea, in most cases,
revealing itself by pathognomonic asymptomatic symptoms or being
confused with typical signs associated with nosological processes
resulting from senility such as delirium and fatigue. However,
persistent diarrhea was one of the unusual incidental findings that
was linked to COVID-19, as taught (NGUYEN et al., 2020).
I N T R O D U C T I O N

3. An epidemiological, retrospective and bibliographic
study was carried out on October 1, 2020, from which an
incursion into the theoretical repertoire on COVID-19 was
carried out, especially researching the use of Boolean
operators the words: COVID-19, EPIDEMIOLOGY, ETIOLOGICAL
AGENT, PATHOGENESIS and ELDERLY in the NCBI, SCIELO,
PUBMED, CLINICALTRIALS and RESEARCHGATE databases,
both in Portuguese and in English. About 167 articles were
found, of which, after reading their abstracts, only 24 were
used.
In terms of inclusion criteria, only articles published
between the years 2020 and 2021 on the subject of COVID-19
among the elderly were accepted, strictly regarding the
pathology, epidemiology and treatment of COVID-19,
including those aimed at the elderly public. , and an article on
viral epidemiology dating from 2005, which addresses the
epidemiological evolution of viral diseases arising from the
coronavirus, especially SARS and MERS. It should be noted
that most of the articles originated from Chinese authors, in
view of the great repercussion of COVID-19 in that country,
and articles focusing on: etiology/epidemiology, pathogenesis
and management of COVID-19 were admitted.
Regarding the issue of risks, this work presented
minimal risk because it is an article based on a bibliographic
review, and it was not necessary to implement the informed
consent, nor to activate the ethics committees in local and
national research, since this scientific piece did not act
directly with humans, but through documental bibliographic
analysis.
It is worth mentioning that the financing was
implemented with the authors' own resources and that the
only figure of the work, located on page 08, was extracted
from material on which there is no limitation by copyright,
since it is a manual drawn up by the Ministry of Brazilian
health.
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4. 02
The analyzed literature indicates that the positive single-
stranded RNA viral etiologic agent attacks the host cell membrane
through an anchoring mechanism favored by the spike protein, which
allows the virus to adhere to the cell surface and initiate its attack,
the lipo oxidizing, which allows its penetration in the cytoplasm.
After that, the cellular machinery will be hijacked and forced to work
for the virus, translating its RNA and retranscribing it, in order to
produce viral clones that will be made available, after their
maturation, into the bloodstream, in order to infect other cells. ,
maintaining the infection process (ROTHAN and BYRAREDDY, 2020;
CHAN et al., 2020).
Regarding the symptomatological issue of COVID-19, the virus
remains latent for 5 days and the evolution to death occurs between
the sixth and the forty-first day, with the 14th day being the median
of this process, which is aggravated in the age group over seventy
years old. It is worth mentioning that the most common symptoms
were fever, dry cough, tiredness, dyspnea, headache, lymphopenia
and persistent diarrhea with a characteristic “ground-glass”
tomographic pattern bilaterally in the lungs, with a severe immune
response that, in young patients, was demobilized. between the 6th
and 21st day of infection (ROTHAN and BYRAREDDY, 2020).
As for the pathogenesis, the presentation of COVID-19 in the
laboratory context was associated with leukopenia, an increase in C-
Reactive protein indicators, with a severe rate of
erythrosedimentation and D-dimer, indicating that there is an
expressive inflammatory action with the participation of pro-
inflammatory cytokines stormy and acute with the presence of
various interleukins, tumor necrosis factor alpha and interferon
gamma (ROTHAN and BYRAREDDY, 2020).
According to Niu et al. (2020), the elderly make up the group
with the highest incidence of infected, with symptoms that do not
follow a regular pattern. However, the presence of fever, dry cough,
dyspnea, persistent diarrhea and tiredness were conditions most
frequently perceived in the patients' symptom repertoire, with
fatality in 8.3% of the positive cases, indicating that lethality
increases proportionally to the age of the subject. and the presence
of cardiovascular, metabolic and immunological comorbidities.

5. Find out more by visiting the links
below:
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https://uii.io/covid_brazil_
https://uii.io/covid_brazil_0
https://uii.io/covid_brazil_1
https://uii.io/covid_brazil_3