COVID-19 has strongly impacted the elderly population with a particularly high mortality rate due to several reasons: sometimes difficult and delayed diagnosis, multimorbidity, immunosenescence, frailty, which seems to be a better prognostic marker than age. Treatment includes both therapies specifically directed against SARS CoV-2 (monoclonal antibodies, systemic corticosteroids, tocilizumab, remdesivir) and symptomatic and palliative treatments. Vaccination, especially the booster, is essential to reduce the risk of infection and severe forms. The emergence of variants is a challenge because of their impact on vaccine and treatment efficacy. Specific studies in the elderly are needed to improve their management.