If you were to ask Patricia Anderson about her well-being, you wouldn’t get a typical response. She stated, “Today, I’m working and I’m fine,” on a recent Tuesday. However, she added that she was bedridden over the weekend due to Long Covid. Patricia used to practice martial arts and didn’t own a car, relying on walking and public transportation in Ann Arbor, Mich., where she works as a medical librarian. Just before she contracted Covid-19 in March 2020, she had recorded an impressive 11,409 steps in a single day.
Covid-19 caused Patricia to experience extreme chills, shortness of breath, a nervous system disorder, and cognitive decline that rendered her unable to read for months. She mentioned, “I was very sick for a long time, and I never really got better.” Some days, her fatigue limited her step count to three digits. Rehabilitation efforts resulted in both progress and setbacks.
Long Covid, or post-Covid, encompasses a wide range of symptoms that can affect anyone who has been infected. However, older patients may experience a greater toll due to their predisposition to certain forms of the illness.
According to the Centers for Disease Control and Prevention, approximately 11% of American adults have developed long Covid after an infection, a decrease from the nearly 19% reported between June 2022 and June 2023. This suggests that some adults are recovering from the syndrome as time goes on.
While people over the age of 60 have lower rates of long Covid overall compared to those aged 30 to 59, this may be attributed to factors such as higher vaccination rates and more cautious behavior like wearing masks and avoiding crowds. Immunologist and researcher Akiko Iwasaki from Yale School of Medicine noted that there may be undiscovered biological factors contributing to the disparity.
Just recently, Patricia, who is now 66, has regained most of her cognitive and some physical functions. She can now manage 3,000 to 4,000 daily steps. However, she remains cautious and wears an N95 mask whenever she goes out, carrying a cane for support during shopping trips. She also worries about her future, as her employer may require more on-site work. Retirement is not a viable option for her, making the situation quite unsettling.
The C.D.C. defines long Covid as symptoms persisting for a month or more after infection, while the World Health Organization considers it as “the continuation or development of new symptoms” three months after the initial infection, lasting for at least two months with no other explanation. The extensive list of long Covid symptoms includes breathing difficulties, cardiovascular and metabolic diseases, kidney disease, gastrointestinal disorders, cognitive loss, fatigue, muscle pain and weakness, and mental health problems.
Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine, emphasizes that long Covid affects almost every organ system in the body and can impact people of all ages. While the likelihood of developing long Covid is higher among those who experience severe illness and require hospitalization, it can also occur after mild infections, even following subsequent bouts of Covid.
Although older individuals are not generally more prone to long Covid, Dr. Al-Aly’s research using large Veterans Affairs databases reveals that they are at a higher risk for four specific symptom clusters: metabolic disorders, cardiovascular problems, gastrointestinal problems, and neurological symptoms.
Jane Wolgemuth, 69, from Monument, Colo., developed cognitive problems months after contracting Covid in June 2022. Despite feeling better after taking the oral antiviral Paxlovid, she noticed a decline in her cognitive abilities, especially while driving. After undergoing tests, she was diagnosed with long Covid. She has tried various treatments and therapies, and though she feels more like herself now, she emphasizes how damaging Covid has been.
Seniors may mistakenly attribute long Covid symptoms to other common age-related conditions. Dr. Monica Verduzco-Gutierrez, chair of rehabilitation medicine at the University of Texas Health Science Center at San Antonio, notes that older individuals may think they are simply aging or need to adjust their medication. Long Covid can also exacerbate existing health problems in seniors, potentially leading to dementia or worsening heart conditions.
Dr. Al-Aly stresses that the best way to prevent long Covid is to prevent Covid itself. As infection rates rise, implementing measures such as mask-wearing and dining outdoors can help reduce infection rates. He also recommends getting vaccinated and receiving booster shots, as studies have shown they reduce the risk of long Covid by 15% to 50%.
For those who do contract Covid, Dr. Al-Aly advises getting tested and considering treatment options like Paxlovid. This antiviral treatment can reduce the risk of long Covid by about 20% for individuals in their 60s and by about 34% for those over 70.
Due to the lack of longitudinal studies, it is still unclear whether older people recover from long Covid at a slower pace. Patients like Patricia and Jane have attempted various treatments, ranging from supplements to physical therapy, but there is currently no medication proven to reverse long Covid.
While certain rehabilitation approaches have shown promise, there are limited programs and clinics specializing in long Covid. Some doctors dismiss long Covid symptoms, leaving patients to search for solutions on their own. However, long Covid patients are coming together to advocate for research and treatment, similar to the AIDS activists of the 1980s.
The Biden administration has recently established a federal office dedicated to long Covid research, and more clinical trials are being conducted. In the meantime, patients rely on support groups like Long Covid Support and the Covid-19 Longhauler Advocacy Project, as well as participating in the Patient-Led Research Collaborative.
Sheila McGrath, 71, from Herndon, Va., experienced her first Covid infection in February 2020 but has been struggling since her second infection five months later. While her health has improved, she still hasn’t fully recovered. Sheila, along with Patricia, now co-hosts an online chat for Long Covid Support, where many individuals express their frustrations and seek validation and treatment options. Nobody wants to be sick, and these patients are fighting together for recognition and support.
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