Long-Term Outcomes and Potential Late-Onset Side Effects of Combination Therapy in Older Immunocompromised Patients Treated for COVID-19

Abstract

The COVID-19 pandemic has affected global health, particularly vulnerable populations such as the aged and immunocompromised individuals who face heightened risks due to age-related physiological changes and comorbidities. Recent cohort studies have indicated that older adults constitute a substantial proportion of hospitalizations and mortality associated with COVID-19, due to decreased physiological reserves and immunosenescence. Combination therapy has been proposed as a primary therapeutic strategy for managing severe COVID-19 in immunocompromised patients, typically involving multiple pharmacological agents, including antivirals, immunomodulatory agents, and supportive care. Compared to monotherapy regimens, recent studies have demonstrated that combination therapies lead to reduced viral load, improved clinical outcomes, and lower mortality rates. Meanwhile, the long-term outcomes of these combination therapies, along with specific details of the post-acute sequelae of COVID-19 (PASC), also referred to as long COVID, in older immunocompromised patients remain under investigation. This review aims to explore these aspects in greater detail, investigating the efficacy of combination therapies in treating COVID-19 among older immunocompromised patients, with a particular focus on their long-term implications.

Keywords: Aged, Combined modality therapy, COVID-19, Immunocompromised, Post-acute COVID-19 syndrome