Covid-19: Infected elderly show unusual symptoms, say doctors

Even before the start of the Covid-19 outbreak in Singapore, we have been informed of the dos and don'ts to prevent the virus; how vulnerable groups like the elderly and those with chronic conditions are more likely to develop complications if infected; and common symptoms that an infected person would display. 

But new studies show deeper insights into these coronavirus symptoms — especially when it comes to the elderly.

Unusual Covid-19 symptoms by older patients

Unlike usual coronavirus symptoms such as fever, persistent coughing or shortness of breath, older people could exhibit none of these symptoms, studies suggest.

Among the unusual symptoms are: Sleeping more than usual, losing orientation to surroundings and becoming dizzy and falling down.

Dr Sylvain Nguyen, a geriatrician at the University of Lausanne Hospital Center in Switzerland sheds light on the possible symptoms that could be observed in older persons if infected with Covid-19. 

A "patient's usual status" could change after being infected by Covid-19 according to Nguyen.

These are typical and atypical symptoms he has listed in a forthcoming paper in the Revue Médicale Suisse, backed by data from hospitals and nursing homes in Switzerland, Italy and France:

• Delirium (a disturbed mental state that results in confused thinking and reduced environmental awareness)
• Falls 
• Fatigue
• Lethargy
• Low blood pressure
• Experiences pain when swallowing
• Fainting
• Diarrhoea
• Nausea
• Vomiting
• Abdominal pain
• Loss of smell and taste

On why this happens, it boils down to how older persons react to illnesses and infections differently due to a weakened immune response.

Besides, an underlying chronic condition could further "mask or interfere with signs of infection" according to Dr. Joseph Ouslander, a professor of geriatric medicine at Florida Atlantic University's Schmidt College of Medicine. 

"Some older people, whether from age-related changes or previous neurologic issues such as a stroke, may have altered cough reflexes.

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Others with cognitive impairment may not be able to communicate their symptoms."

A senior with heart disease could experience these unusual symptoms without having a fever or a cough, and only respiratory symptoms such as sneezing from time to time, described Dr Quratulain Syed, an Atlanta geriatrician.

The change in routines in older persons could also be a factor to a weakened immune response, with decreased physical movement at home, nursing homes and others. 

In addition, safe distancing measures put in place could have led to family members managing older persons' medication less, with less control over their chronic conditions. 

These factors and unusual Covid-19 symptoms make it challenging to ascertain if older persons have indeed contracted the virus, therefore presenting a greater danger when they do not get timely treatment. 

What seniors really need during the Covid-19 pandemic

At least on the frontlines, Nguyen said that physicians should ensure that older patients' symptoms are carefully assessed. 

And for those who know of an older person at home, doctors advise the importance of reading into early signs to prevent the possible spread of the virus, considering that symptoms could be hidden and unlike the usual. 

Doing so can help seniors get needed care before they face worsening conditions. If not curbed, seniors could also unknowingly spread the infection as they travel out of their homes. 

For the latest updates on the coronavirus, visit here.

This article was first published in theAsianparent.