The ‘Health Collapse Spiral’: A 35‐Month Longitudinal Case Study of Physiological Reserve Depletion in a Centenarian Following COVID ‐19

ABSTRACT

This 35‐month case report documents irreversible physiological reserve depletion in a centenarian multimorbid man after COVID‐19. Prior to infection, he maintained precarious homeostasis for 17 years despite severe frailty (CFS 7), with stable CKD stage 3a (eGFR 58.3 mL/min/1.73 m ² ) and albumin 36.2 g/L. Acute COVID‐19 triggered a health collapse spiral (a stepwise, irreversible multisystem deterioration driven by cumulative stressors), characterized by: eGFR decline > 60% (58.3 to 22.4 mL/min/1.73 m ² ), albumin drop to 28 g/L, CRP surge > 360‐fold (peak 254.2 mg/L), Barthel Index loss from 80 to 0, and predominant recurrent MDR/PDR Pseudomonas aeruginosa infections (42.9%). Death followed palliative transition. This case suggests that acute infections irreversibly disrupt centenarian homeostasis, with eGFR, albumin, and CRP serving as reliable reserve proxies, and that reserve‐centered management is essential for this population.