Long symptoms of covid are often overlooked in the elderly – The Washington Post

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Nearly 18 months after contracting the coronavirus and spending weeks in the hospital, Terry Bell struggles with hanging shirts and pants after washing clothes.

Lifting clothes, raising hands, stacking things in the closet leaves Bella breathless and often causes severe fatigue. He walks with a cane, and only for short distances. He is 50 pounds lighter than when he was hit by covid-19, a disease caused by a coronavirus.

Bell, 70, is among millions of older people who have struggled with covid for a long time – a population that receives little attention, although research suggests that older people are more likely to develop a poorly understood condition than younger or middle-aged adults.

Long covid refers to current or new health problems that at least occur four weeks after covid infection, according to the Centers for Disease Control and Prevention. Much about the condition is confusing: there is no diagnostic test to confirm it, there is no standard definition of the disease, and there is no way to predict who will be affected. Common symptomswhich can last for months or years, include fatigue, shortness of breath, increased heart rate, muscle and joint pain, sleep disorders and problems with attention, concentration, language and memory – a set of difficulties known as brain fog.

Persistent inflammation or a dysfunctional immune response may be responsible, along with reservoirs of virus remaining in the body, small blood clots, or residual damage to the heart, lungs, circulatory system, brain, kidneys, or other organs.

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It is only now that the impact on older adults is beginning to be documented. In a study published in the journal BMJ, the researchers assessed this 32 percent of seniors in the United States who survived covid infection had symptoms of long-term covid up to four months after infection – more than double rate of 14 percent an earlier study found in adults aged 18 to 64 years. (Other studies suggest that symptoms can last much longer, a year or more.)

The BMJ study examined more than 87,000 adults aged 65 and older who had a covid infection in 2020, relying on data from claims from UnitedHealth Group’s Medicare Advantage plans. It includes symptoms that lasted for 21 days or more after infection, which is a shorter period than the CDC uses in its long definition of covida. Data include both elderly people who were hospitalized for covid (27 percent) and those who were not (73 percent).

A study released last month by the CDC found that 1 in 4 older adults who survived covid experienced at least 1 in 26 common symptoms associated with long-term covidcompared with 1 in every 5 people aged 18 to 64 years.

The higher rate of post-covid symptoms in the elderly is probably due to the higher incidence of chronic diseases and physical vulnerability in this population – traits that have led to higher load severe illness, hospitalization, and death among the elderly during a pandemic.

“On average, older people are less resilient. They do not have the same ability to recover from a serious illness, ”said Ken Cohen, co-author of the study and executive director of translational research for Optum Care. Optum Care is a network of doctor’s offices owned by the UnitedHealth Group.

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For older people with long-term covid, the consequences can be devastating: the onset of disability, inability to work, reduced ability to perform daily activities, and a lower quality of life.

But in many older people, covid is difficult to recognize for a long time.

“The challenge is that non-specific symptoms such as fatigue, weakness, pain, confusion and increased weakness are things we often see in seriously ill elderly people. Or people might think, ‘It’s just part of aging,’ said Charles Thomas Alexander Semelka, a postdoctoral fellow in geriatric medicine at Wake Forest University.

Ann Morse, 72, of Nashville, was diagnosed with kovid in November 2020 and recovered at home after going to the emergency room and subsequent home visits by nurses every few days. She soon began to have problems with memory, attention and speech, as well as problems with sleep and severe fatigue. Although it has improved somewhat, there are still a few cognitive problems and fatigue.

“What was frustrating was that I would tell people about my symptoms and they would say,‘ Oh, we’re like that, too ’, like it’s about aging,” she told me. “I’m like, too, but this happened to me suddenly, almost overnight.”

50 percent of people who survive covid-19 face long-term symptoms, the study finds

Bell, a singer and songwriter from Nashville, found it difficult to get adequate follow-up attention after spending two weeks in intensive care and an additional five weeks in a nursing home on rehabilitation therapy.

“I didn’t get answers from my regular doctors about my breathing and other problems,” he said. “They said you were taking some over-the-counter medications for sinuses and things like that.” Bell said his real recovery began after he was recommended to specialists at Vanderbilt University Medical Center.

‘Significant differences’

James Jackson, director of long-term outcomes at the Vanderbilt Center for Critical Illness, Brain Dysfunction and Survival, leads several long covid support groups attended by Morse and Bell and has worked with hundreds of similar patients. He said he estimates that about a third of seniors have some degree of cognitive impairment.

“We know there are significant differences between the younger and older brains,” Jackson said. “Younger brains are more plastic and more efficient at reconstitution, and our younger patients seem to be able to regain their cognitive functions faster.”

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In extreme cases, covid infections can lead to dementia. This may be because older adults who are severely ill are at high risk developing delirium – acute and sudden change in mental status – which is associated with subsequent development of dementiaHe said Liron Sinvanigeriatrician and assistant professor at the Feinstein Institute for Medical Research Northwell Health in Manhasset, NY

The brains of elderly patients could also be injured due to lack of oxygen or inflammation. Or the disease processes that underlie dementia may already be underway, and covid infection may serve as a turning point, accelerating the onset of symptoms.

Conducted research Sinvania and colleagues, published in March, found that 13 percent of covid patients over the age of 65 and hospitalized at Northwell Health in March 2020 or April 2020 had evidence of dementia a year later.

Thomas Gut, associate chairman of medicine at Staten Island University Hospital, which opened one of the first long-term covid clinics in the United States, noted that covid disease can push older adults with pre-existing conditions such as heart failure or lung disease “Over the edge” to more severe damage.

Especially the elderly, he said, “find it difficult to attribute what is directly related to the covid and what is the progression of the condition they already have.”

That wasn’t true for Richard Gard, 67, who lives not far from New Haven, Conn., A self-proclaimed “very healthy and capable” sailor, diver and music teacher at Yale University who contracted covid in March 2020. He was the first covid the patient was treated at Yale New Haven Hospital, where he was critically ill for 2½ weeks, including five days in intensive care and three days on a respirator.

In the past two years, Gard has spent more than two months in hospital, usually for heart-like symptoms.

“If I tried to walk up the stairs or 10 feet, I would almost faint from exhaustion and the symptoms would start – severe chest pain radiating to my neck, difficulty breathing, sweating,” he said.

Erica Spatzdirector of the cardiovascular health prevention program at Yale, is one of Gard’s doctors.

“The more severe the covid infection and the older you are, the more likely you are to have cardiovascular complications afterwards,” she said. Complications include weakening of the heart muscle, blood clots, abnormal heart rhythms, damage to the vascular system, and high blood pressure.

Garda’s life changed in ways he couldn’t even imagine. Unable to work, he takes 22 medications and can still walk for only 10 minutes on flat terrain. Post-traumatic stress disorder is a common, unwanted companion.

“A lot of times it was hard to keep going, but I tell myself I just have to get up and try one more time,” he said. “Every day when I get a little better, I tell myself to add another day or week to my life.”

Judith Graham is a columnist for Kaiser Health News, which produces in – depth journalism on health. KHN is a program of the Kaiser Family Foundation, a non-profit organization that provides information on the nation’s health problems.

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