Long-lasting COVID presents special challenges for older adults

Patricia Anderson, who has endured Covid symptoms for 40 months, now uses a folding seat cane for stability. “I was very ill for a long time, and I never really recovered” (Emily Elkonin for The New York Times)

ask to Patricia Anderson That’s how it is, and you probably won’t get a regular answer. He recently said on Tuesday, “Today I work and I am fine.” “Saturday and Sunday I lay in bed. long covid It’s a roller coaster.”

Before the pandemic, Anderson practiced martial arts and did not own a car, instead walking and taking buses in the Ann Arbor, Michigan area, where she works as a medical librarian. Just before he was infected with COVID-19 in March 2020, he had taken 11,409 steps in a day – yes, keep track.

The virus caused extreme chills, difficulty breathing, nervous system disorders, and cognitive impairment to the extent that, for months, Anderson was unable to read a book.

“I’ve been sick for a long time i’ve never been better“, she claimed. In a few days, her step count was down to three digits due to exhaustion. Rehabilitation efforts led to progress and then relapse.

Dozens of symptoms collectively known as long-lasting COVID, or post-COVID, can put any infected person out of business. But they mostly affect some elderly patients, who may be at higher risk of some forms of the disease.

around 11% of US adults develop long-lasting COVID after infectionThe Centers for Disease Control and Prevention (CDC) reported last month that the number is expected to decline by about 19 percent between June 2022 and June 2023. The numbers suggest that some adults outgrow the syndrome as time passes.

People over the age of 60 actually have a lower rate of long-term COVID survival than people between the ages of 30 and 59. This may reflect higher vaccination and booster rates among older Americans, or more protective behaviors, such as wearing masks and avoiding crowds.

“Too There may be biological factors we don’t yet understand”, said Akiko Iwasaki, an immunologist and researcher at Yale School of Medicine. He said, although knowledge about long-term COVID has increased, much remains to be learned about the disease.

Recently, Anderson, 66, has recovered most of her cognitive and some physical functions; Now he can walk 3,000 to 4,000 steps in a day. But she wears an N95 mask whenever she goes out and carries a cane to sit with, so “if I go shopping and run out of steam in the middle of the aisle, I can relax.”

And he is worried. Your boss has given you permission to continue working remotely, but what if the library becomes more demanding of your current weekly hours in person? “I can’t afford to retire,” he said. “It scares me a lot”.

According to the CDC, chronic COVID begins when symptoms persist a month or more after infection. But the World Health Organization defines chronic COVID as “the persistence or development of new symptoms” three months after the initial infection, lasting at least two months without any other explanation.

The extensive list of long-lasting COVID symptoms includes respiratory difficulties, cardiovascular and metabolic diseases, kidney disease, gastrointestinal disorders, cognitive impairment, fatigue, muscle pain and weakness, and mental health problems.

,There is almost no organ system that is not affected by Covid for a long timeThese symptoms can persist for up to two years, said Ziad Al-Ali, a public health clinical researcher at Washington University School of Medicine and lead author of a recent study.

“It can affect almost everyone throughout life, from children to the elderly,” he said.

Although chronic COVID is more likely to affect people who become severely ill with COVID and require hospitalization – and chronic COVID symptoms last longer in these patients – it is more common for mild Can also occur after infection. It may appear after the first outbreak of Covid, or after the second or fourth.

Although older people are generally not at higher risk of long-term COVID, Al-Aly’s research using the Department of Veterans Affairs’ large database suggests they are at a higher risk of suffering . four distinct groups of symptoms,

Metabolic disorders, such as new onset diabetes and high cholesterol.

– Cardiovascular problems, such as heart disease, heart attack and arrhythmias such as atrial fibrillation.

– Gastrointestinal problems, such as diarrhea and constipation, pancreatitis and liver disease.

stroke, cognitive impairment and other neurological symptoms

Jane Wolgemuth with her husband got infected with COVID in June 2022. “He got over it in two days,” she recalled. “I was in bed for a week.”

Both felt better after taking the oral antiviral paxlovid. However, months later, Monument, Colo. Wolgemuth, 69, a retired bank employee in the U.S., began to notice cognitive problems, especially while driving.

Paxlovid, Pfizer’s antiviral (Reuters)

“I didn’t react fast enough,” he said.brain fog was getting over me,

Older people may confuse chronic Covid with other conditions that become common in later life. “They may think, ‘Maybe I’m getting old or I need to adjust my blood pressure medication,'” said Monica Verduzco-Gutierrez, MD, professor of rehabilitation medicine at the University of Texas Health Science Center at San Antonio. She is the co-author of the American Academy of Physical Medicine and Rehabilitation guidelines for the treatment of chronic COVID.

Long-term COVID can also exacerbate health problems that many elderly people are already suffering from. “If they have mild cognitive impairment, do they go into dementia? I’ve seen it,” Verduzco-Gutierrez said. Mild heart conditions can become severe, reducing an older person’s mobility and increasing the risk of falls.

“The best way in the world to prevent long-term COVID is to prevent COVID,” Al-Aly said. As infection rates rise across the country, wearing masks again indoors and eating out at restaurants can help reduce infections.

,There is definitely a need to get vaccinated.“, she indicated. According to studies, “vaccinations and boosters reduce the risk of long-term COVID by 15 to 50 percent, but do not eliminate.”

“If you are infected, get tested to make sure it is COVID, then call a provider as soon as possible and see if you are a good fit for Paxlovid,” he said. Antiviral treatment reduces the risk of long-term COVID infection by about 20 percent for people over the age of 60 and by 34 percent for people over the age of 70.

With no longitudinal studies yet, it is unclear whether older people recover more slowly from long-term COVID. Patients like Anderson and Wollgemuth have tried a variety of treatments: supplements, electrolytes, compression garments, and various physical therapy methods. Iwasaki concluded, “But we don’t have any drugs that can reverse it.”

New York Times 2023

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