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Coronavirus: Do seniors have different COVID-19 symptoms?

For the past eight weeks, public health officials have told us about the three main symptoms of the COVID-19 virus.

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We have been warned to look out for a fever, a dry cough and shortness of breath.

But doctors this week are warning of a different set of symptoms that seem to be hitting older adults exposed to the virus.

According to a story from Kaiser Health News, older adults have been experiencing “atypical” symptoms that may be misread as something else. That may happen in part because the immune systems of older people are less robust than they once were, researchers note.

A weaker immune system combined with underlying conditions may mask infection, Dr. Joseph Ouslander, a professor of geriatric medicine at Florida Atlantic University’s Schmidt College of Medicine, said.

At advanced ages, “someone’s immune response may be blunted and their ability to regulate temperature may be altered,” Ouslander told Kaiser Health News.

“Underlying chronic illnesses can mask or interfere with signs of infection,” he said. “Some older people, whether from age-related changes or previous neurologic issues such as a stroke, may have altered cough reflexes. Others with cognitive impairment may not be able to communicate their symptoms.”

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In addition, doctors say symptoms of a COVID-19 infection can look like many other conditions in seniors.

Dr. Quratulain Syed, a physician in Atlanta, said she treated a patient who had heart disease, diabetes and some cognitive impairment. The man, who turned out to have a COVID-19 infection, had symptoms of profound lethargy, incontinence and a refusal to walk.

The Kaiser Health News story points out that there is not a great effort being put into catalog symptoms in older patients. However, Dr. Sylvain Nguyen, a geriatrician at the University of Lausanne Hospital Center in Switzerland, has compiled a list of typical and atypical symptoms seen in older COVID-19 patients.

The study was based on anecdotal evidence and will be published in a forthcoming paper in the Revue Médicale Suisse. The symptoms Nguyen found included:

The symptoms Nguyen found included:

  • Changes in a patient's usual status
  • Delirium
  • Falls
  • Fatigue
  • Lethargy
  • Low blood pressure
  • Painful swallowing
  • Fainting
  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal pain
  • Loss of smell and taste

According to Nguyen, the symptoms were compiled from data submitted by hospitals and nursing homes in Switzerland, Italy and France.

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