A sick nursing home resident lies in bed
Credit: RUBEN BONILLA GONZALO/Getty Images Plus

Long COVID, or new or ongoing or health problems at least four weeks after a COVID infection, may hit seniors differently, with symptoms that mimic the effects of aging leading to oversight or misdiagnosis.

Come occurrences with long COVID include shortness of breath, an elevated heart rate and muscle and joint pain; in seniors, they also often include respiratory failure, dementia and post-viral fatigue, as reported in the journal BMJ late last year.

The vague nature of defining long COVID and the wide range of symptoms may result in millions of those over 65 having changes in cognition, sleep patterns or concentration following COVID written off as minor, or at least separate, conditions. And many now battling significant life changes after surviving the virus were likely never hospitalized for COVID,  adding to doctors’ difficulty in accurately identifying long-haul symptoms.

“The challenge is that nonspecific symptoms such as fatigue, weakness, pain, confusion, and increased frailty are things we often see in seriously ill older adults. Or people may think, ‘That’s just part of aging,’” Charles Thomas Alexander Semelka, a postdoctoral fellow in geriatric medicine at Wake Forest University, recently told Kaiser Health News.

Terry Bell, 70, of Nashville, told the news organization he struggles to get needed follow-up care for his long-COVID symptoms after two weeks in intensive care and another five in a nursing home.

As with the BMJ study that looked at seniors, about three-quarters of participants in a massive new FAIR Health study out Wednesday were not hospitalized when first diagnosed with COVID. The nonprofit organization found younger patients, ages 36 to 50, were actually most likely to be diagnosed with post-COVID conditions at nearly 35%. About six percent of seniors had the same diagnosis in the health records. The three diagnoses most common across ages?  Abnormalities of breathing, cough, and malaise and fatigue.

The earlier BMJ study looked at new medical conditions seniors developed after COVID, not necessarily their diagnosis. It estimated that 32% of older adults in the U.S. who survived COVID infections had symptoms of long COVID up to four months later.

Kaiser Health said that by applying the study’s findings to the latest data from the CDC, it calculated up to 2.5 million older adults may have been affected by long COVID. 

Predicting and identifying those patients earlier, regardless of whether they live in the community or enter nursing homes, will be a key to future treatment.

Earlier this week, the Center for Infectious Disease and Policy (CIDRAP), announced that machine-learning models created by a National Institutes of Health-funded research team have been able to identify, with high accuracy, patients likely to have long COVID.

“Characterizing, diagnosing, treating, and caring for patients with long COVID has been challenging due to heterogeneous signs and symptoms that evolve over long trajectories. The effect of long COVID on patients’ quality of life and ability to work can be profound,” the researchers reported in The Lancet Digital Health on May 16.