COVID-19 has posed a considerable threat to all aspects of older Americans’ lives. The pandemic generated acute illness, emergency department (ED) visits, hospitalization, respiratory failure, and death. Pandemic-associated social isolation and loneliness further endangered older adults. Recovery from COVID-19 illness has commonly been followed by chronic symptoms, which may also precipitate ED visits. While vaccination has mitigated risks of serious illness requiring hospitalization, a booster dose is required to sustain protection. New treatments and therapies, including monoclonal antibodies and antiviral agents, have shown efficacy for older adults who are at risk of hospitalization. Older adults remain vulnerable in 2022, after two years of the COVID-19 pandemic. Emergency care for older patients is now challenged with health system staffing shortages and diminished access to care in community programs & skilled nursing facilities. This article attempts to synthesize the avalanche of discovery and innovation into a narrative review focused on the emergency and immediate post- ED care of the aging adult patients both during and as a result of the COVID-19 pandemic.