When you ask Patricia Anderson how she’s doing, you won’t get a typical response. “Today, I’m working and I’m fine,” she expressed on a recent Tuesday. “Saturday and Sunday, I was bedridden. Long Covid is a roller coaster.”
Before the pandemic, Ms. Anderson was active in martial arts and didn’t own a car. Instead, she relied on walking and taking buses around Ann Arbor, Michigan, where she works as a medical librarian. Just before contracting Covid-19 in March 2020, she managed an impressive 11,409 steps in a single day.
Unfortunately, the virus caused her extreme symptoms, including chills, shortness of breath, a nervous system disorder, and cognitive decline that lasted for months. At one point, Ms. Anderson could not even read a book. “I was very sick for a long time, and I never really recovered,” she explained. Some days, fatigue limited her step count to three-digit numbers. Despite attempts at rehabilitation, she experienced progress followed by setbacks.
Long Covid, or post-Covid, encompasses a variety of symptoms that can affect anyone who has been infected. However, these symptoms have a particularly heavy impact on older patients, who may be more susceptible to certain forms of the illness.
According to the Centers for Disease Control and Prevention, about 11% of American adults have developed long Covid after an infection, a decrease from the almost 19% recorded from June 2022 to June 2023. This suggests that, over time, some adults are recovering from the syndrome.
Interestingly, adults over the age of 60 actually have lower rates of long Covid compared to those aged 30 to 59. This could be due to higher vaccination and booster rates among older Americans, or their more cautious behaviors like wearing masks and avoiding crowds.
However, as Akiko Iwasaki, an immunologist and researcher at Yale School of Medicine, notes, there may be other biological factors yet to be understood. Despite increased knowledge about long Covid, much remains unknown about this disease.
Only recently, at the age of 66, has Ms. Anderson regained most of her cognitive and physical function. She can now manage 3,000 to 4,000 steps per day. However, she continues to take precautions, such as wearing an N95 mask and carrying a sitting cane, in case she needs to rest while shopping. She also worries about her job and the potential for increasing on-site requirements. Retirement is not a viable option for her, so the uncertainty is frightening.
According to the CDC, long Covid is defined as symptoms persisting for a month or longer after infection. However, the World Health Organization’s definition includes the continuation or development of new symptoms three months after the initial infection, lasting at least two months with no other explanation.
The extensive list of long Covid symptoms covers breathing difficulties, cardiovascular and metabolic diseases, kidney disease, gastrointestinal disorders, cognitive decline, fatigue, muscle pain and weakness, and mental health problems. Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine, explains, “There’s almost no organ system long Covid doesn’t touch.” He adds that long Covid can affect everyone from children to older adults.
Although long Covid is more likely to impact individuals who become severely ill with Covid and require hospitalization, it can also develop from mild infections. It can occur after the first, second, or even fourth bout of Covid.
While older people may not be more prone to long Covid overall, Dr. Al-Aly’s research with large Veterans Affairs databases shows that they are more at risk for four specific groups of symptoms: metabolic disorders, cardiovascular problems, gastrointestinal problems, and neurological symptoms like strokes and cognitive decline.
Jane Wolgemuth, a 69-year-old retired bank employee in Colorado, experienced cognitive problems after recovering from Covid. Despite feeling better with the help of the oral antiviral Paxlovid, she noticed issues with reaction time, particularly while driving. After normal test results, she was diagnosed with long Covid. She has been using supplements, light therapy, and stretching her walking distance to cope. However, she emphasizes the destructive nature of the virus.
Long Covid can often be mistaken for other conditions common among older individuals. Dr. Monica Verduzco-Gutierrez, the chair of rehabilitation medicine at the University of Texas Health Science Center at San Antonio, explains, “They may think, ‘Maybe I’m just aging or I need to adjust my blood pressure medication.'” She has co-authored guidance statements for treating long Covid from the American Academy of Physical Medicine and Rehabilitation.
Furthermore, long Covid can worsen existing health problems faced by seniors. Dr. Verduzco-Gutierrez notes that mild cognitive impairment can progress into dementia, and a mild heart condition can become more serious, reducing mobility and increasing the risk of falls.
Dr. Al-Aly emphasizes that the best way to prevent long Covid is to prevent Covid itself. As infection rates rise again across the country, actions like wearing masks in close quarters and dining outdoors can help reduce transmission.
He also urges individuals to get vaccinated and boosted, as these significantly reduce the risk of long Covid. Studies have found that vaccination and boosters can decrease this risk by 15% to 50%.
For those already infected, getting tested and seeking treatment as soon as possible is crucial. Dr. Al-Aly recommends considering the antiviral treatment Paxlovid, which can reduce the risk of long Covid by approximately 20% for those in their 60s and by around 34% for those over 70.
Unfortunately, there is still uncertainty regarding the recovery process for older individuals with long Covid. Patients like Ms. Anderson and Ms. Wolgemuth have tried various treatments, but there is no medicine that has been proven to reverse the condition yet.
Effective rehabilitation approaches exist, but there is a lack of programs and clinics experienced in treating long Covid. Some doctors even dismiss long Covid symptoms, leaving patients to search for solutions on their own. These individuals, as Dr. Iwasaki compares them, are rising up 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 leading long Covid research, and more clinical trials are underway. In the meantime, many patients rely on support groups and participate in patient-led research initiatives.
Sheila McGrath, a 71-year-old resident of Virginia, recovered from her first Covid infection but has continued to suffer since her second bout. Though her health has improved, she hasn’t fully recovered. Alongside Ms. Anderson, she co-hosts an online chat for Long Covid Support, where frustrated individuals often find solace. Patients in these groups face challenges such as being dismissed, and their conditions being labeled as psychosomatic.
In conclusion, long Covid can have a significant impact on older individuals, exacerbating their existing health problems and requiring them to navigate unfamiliar challenges. Prevention through vaccination, masking, and other safety measures remains crucial, while efforts are made to improve understanding and treatment of long Covid.
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