Older survivors of COVID-19 are more likely to experience Long COVID than younger patients, but discerning between Long COVID and underlying conditions like heart disease or mild cognitive dysfunction–common conditions in seniors–can be difficult. On top of that, Long COVID has no diagnostic protocol or standard treatment. Consequently, seniors can miss out on much-needed medical care.

Judith Graham of Kaiser Health News recently asked 12 healthcare experts to weigh in on what seniors should do if they still feel sick several weeks after contracting COVID-19. Here’s what they said.* 

Advice from the experts

The experts interviewed offered five (5) pieces of advice.

Be proactive in seeking out medical help

Liron Sinvani, M.D., director of Northwell Health’s geriatric hospitalist service, recommends that older adults seek medical evaluation if they or their caregiver notice any oddities, such as significant weight loss, muscle weakness, forgetfulness, etc. a month or two after COVID. 

If they deem it necessary, your primary care physician may refer you to a Long COVID specialist or clinic. Wait times to see specialists can be lengthy, but don’t give up. Dozens of interdisciplinary clinics provide post-COVID care, and telehealth appointments are often available.

You also have opportunities to receive treatment by enrolling in Long COVID-related clinical trials and other research studies such as the National Institutes of Health’s nationwide RECOVER study. 

Look for comprehensive care

The University of Southern California’s Keck (Long) COVID Recovery Clinic exemplifies a comprehensive approach to Long COVID care. The clinic first makes sure any underlying conditions are well under control, and then checks for any newly developed conditions. 

If preexisting and new conditions are properly managed and further tests come back negative, “there is probably an element of long covid,” says clinic co-director Caitlin McAuley. From there, the clinic focuses on helping seniors regain functionality regarding daily tasks and activities. 

This typically takes several months of physical, occupational, and cognitive therapy. Further cognitive therapy for seniors concerned about post-COVID brain dysfunction is also provided.

Resume activity slowly 

Following severe illness, seniors are often left feeling weak and deconditioned, says Dr. Erica Spatz, an associate professor of cardiology at the Yale School of Medicine, especially after weeks of bedrest or little movement. This can lead to fast heart rate and dizziness upon standing, or postural orthostatic tachycardia syndrome (POTS). To those patients who find even walking to be a challenge, Spatz advises:

• Consuming more fluids and salt, and wearing compression socks and abdominal binders.
• Returning to exercise by starting with a recumbent bike or rower for just a few minutes, and adding a couple more minutes each week.
• Moving to a semi-recumbent or conventional stationary bike after about a month. After another month, she says, try walking a short distance.

This go-slow approach for seniors applies to brain-related Long COVID issues, as well. 

Set priorities

It can take weeks to months for seniors to recover from COVID, even after mild infection. Greg Vanichkachorn, M.D., M.P.H., Mayo Clinic’s director of COVID Activity Rehabilitation Program, says older patients must give themselves time to get better, as they appear to be taking the longest to recover from Long COVID.

Vanichkachorn says older patients need to learn to set priorities and pace themselves,  otherwise post-exertional malaise can set in, making things worse.

Advice for healthcare providers

There are certain factors that make seniors with Long COVID especially vulnerable:

• Low economic status
• Frailty
• Physical or mental disability
• Social isolation

These marginalized older adults with poor health status and less access to care cause experts particular concern. Moreover, many older adults aren’t used to needing help, and may feel ashamed to ask.

Says James Jackson, Psy.D., who directs Vanderbilt University’s long-term outcomes at the Critical Illness, Brain Dysfunction, and Survivorship Center, “You really have to check in with people who are older and vulnerable and who have had COVID and not just make assumptions that they’re fine just because they tell you they are. We need to be more proactive in engaging them and finding out, really, how they are.”

*Graham, J. (2022, May 31). Got Long COVID? Medical Expertise Is Vital, and Seniors Should Prepare to Go Slow. Kaiser Health News. https://khn.org/news/article/long-covid-older-adults-medical-advice

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