A recent study has shown that nearly one third of Covid-19 patients over age 65 developed a new medical issue after their diagnosis. Covid-19 patients of all ages are experiencing aftereffects from having Covid-19, but seniors are more susceptible than other age groups. Medical researchers are still investigating long-haul Covid-19’s reach and impact on patients, so what should seniors and caregivers in San Diego watch for?

What is Long-Haul Covid?

Formally called “post-acute sequelae of COVID-19 (PASC)”, ‘long COVID’ refers to the continuation of Covid-19 symptoms or emergence of new symptoms after the initial ‘acute’ phase of the illness has passed. Long COVID, also called long-haul or chronic COVID, can affect Covid-19 patients of all ages, whether they had asymptomatic, mild, or severe cases of COVID-19. Doctors don’t know why some people develop long COVID and others don’t, but so far patients who experienced six or more symptoms during the initial seven days of illness, women and seniors are the most likely patients. Yale Medicine’s website says that “Researchers do not yet know the prevalence of long COVID, though the condition is common. A recent study in the U.S. found that approximately one-third of people who had COVID-19 report persistent symptoms up to 9 months after the initial illness.” The symptoms of long COVID can be any of the following, with the most commonly reported in bold:

  • Fatigue
  • Headache
  • Shortness of breath
  • Chest pain or discomfort
  • Cough
  • Persistent loss of smell and/or taste
  • Joint pain; muscle aches and pain/weakness
  • Sore throat
  • Memory loss
  • Brain fog (difficulty concentrating, sense of confusion or disorientation)
  • Dizziness
  • Low-grade, intermittent fever
  • Rapid or irregular heartbeat (palpitations)
  • Anxiety
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Insomnia
  • Earache, hearing loss, and/or ringing in ears (tinnitus)
  • Rashes
  • Diarrhea, nausea, and/or abdominal pain
  • Diminished appetite
  • Hair loss

Long COVID in Seniors

A retrospective cohort study published in December 2021 analyzed “the risk of persistent and new clinical sequelae in adults aged ≥65 years after the acute phase of SARS-CoV-2 infection.” Doctors from Optum Labs, in Minnesota, Optum Global Advantage in Ireland and Harvard’s T H Chan School of Public Health in Boston analyzed the health insurance records of 133,366 older adults in the United States. Each patient was 65 years old or older and received their COVID-19 diagnosis before April 1, 2020. The study compared these patients to three other groups of people 65 and over: those didn’t have COVID-19 in 2019, those who didn’t have COVID-19 in 2020, and those who had a lower respiratory tract infection that wasn’t COVID-19 in the same period. There’s no analysis showing whether seniors and elderly in home care are more or less at risk.

The researchers looked for new or persistent conditions logged in their medical records three or more weeks after their COVID-19 diagnosis. According to the study, the authors found that “32% of the participants who had a SARS-CoV-2 infection in 2020 sought medical attention for a new or persistent condition. This was 11% higher than the comparison group (who did not have COVID-19) from 2020.”

What Post-Acute Symptoms Are Seniors Developing?

The group of senior patients in the study who had COVID-19 before April 1, 2020 developed a range of high-risk conditions. MedicalNewsToday.com listed the symptoms reported in the study:

  • respiratory failure,
  • fatigue,
  • high blood pressure,
  • memory issues,
  • kidney injury,
  • mental health-related diagnoses,
  • hypercoagulability — which occurs when the blood clots more easily — and
  • cardiac rhythm disorders.

Are Seniors Getting Long COVID?

The list of symptoms that the long COVID patients of all ages are reporting isn’t the same as the list of high-risk conditions that the senior patients in the study developed. Do these seniors simply have long COVID, or are COVID patients over age 65 experiencing something else, or something worse? Doctors know that COVID patients who were seriously ill, hospitalized, in the ICU or on a respirator had a systemic inflammatory response that typically damaged organs. Seniors were at higher risk for this kind of severe case of COVID, accounting for the majority of COVID hospitalizations before the vaccine was available and the majority of breakthrough cases after vaccination. Immune system strength declines with age, so even milder or asymptomatic cases of COVID can tax the immune system. A weakened immune system can’t do its usual work as well, leaving a gap in the body’s defenses against stroke, cancer and heart attacks. Were the post-COVID conditions reported in the study were going to develop in the future, and just arrived faster? Or are they conditions somehow caused by the COVID virus itself that emerged in the aftermath of the illness? Dr. Alicia Arbaje, after reviewing the study, says “[I]f we think about what protects us from heart attacks, strokes, and cancer and other things, it’s our immune system. It’s protecting against inflammation. And when the immune system receives such a hit, I think it may have less ability, defenses, or physiological reserve to do its other duties, like monitoring for cancer cells, monitoring for the things it normally does. So COVID-19 may accelerate what was already coming if we have tendencies that were coming our way, or it may create new injuries that the body then has to deal with.”

What Does This Mean for Seniors?

New COVID-19 infections are decreasing everywhere, and San Diego County’s seven-day average of new cases is in the low hundreds as of mid-April. But we need to continue to be careful about exposing ourselves to possible infection because even asymptomatic patients can develop long COVID. And if you’ve had COVID, be aware of the possible conditions that can develop afterward.